Organization
DEACONESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4949 HEALTHY WAY STE D, EVANSVILLE, IN 47715-1180
(812) 450-7455
(812) 450-2960
Mailing address
329 W COLUMBIA ST, EVANSVILLE, IN 47710-1757
(812) 450-7455
(812) 450-2960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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