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
4015 GATEWAY BLVD, NEWBURGH, IN 47630-8925
(812) 858-9400
(812) 858-9571
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 858-9400
(812) 858-9571
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
231H00000X
Audiologist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200910700A
—
IN
Enumeration date
08/18/2008
Last updated
09/16/2020
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