Organization
DEACONESS SPECIALTY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (SECRETARY/TREASURER)
(812) 450-3296
Entity
Organization
Contact information
Practice address
2200 E PARRISH AVE, OWENSBORO, KY 42303-1449
(812) 450-7899
(812) 450-6029
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
(812) 450-7899
(812) 450-6029
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/20/2018
Last updated
11/05/2021
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