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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
1300 MERRITT DR STE 110, HENDERSON, KY 42420-2788
(270) 827-8811
(270) 827-8855
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
08/30/2019
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