Organization
DEACONESS CLINIC, INC
Active
Other names
Deaconess Clinic I
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4011 GATEWAY BLVD STE 100, NEWBURGH, IN 47630-8947
(812) 858-2100
(812) 858-2120
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 858-2100
(812) 858-2120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/23/2012
Last updated
01/14/2022
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