Organization
DEACONESS SPECIALTY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (SECRETARY-TREASURER)
(812) 450-3296
Entity
Organization
Contact information
Practice address
1103 W MAIN ST, CARMI, IL 62821-1380
(618) 842-4617
(618) 380-4565
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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