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Organization

DEACONESS CLINIC, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization

Contact information

Practice address
4209 GATEWAY BLVD, NEWBURGH, IN 47630-8900
(812) 853-5300
(812) 858-4660
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 853-5300
(812) 858-4660

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
207Q00000X
Family Medicine Physician
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
208000000X
Pediatrics Physician
Primary
2080P0202X
Pediatric Cardiology Physician
2080P0205X
Pediatric Endocrinology Physician
2080P0206X
Pediatric Gastroenterology Physician
2080P0208X
Pediatric Infectious Diseases Physician
2080P0210X
Pediatric Nephrology Physician
2080P0214X
Pediatric Pulmonology Physician
2086S0120X
Pediatric Surgery Physician
208800000X
Urology Physician
2088P0231X
Pediatric Urology Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200910700F
IN
Enumeration date
08/12/2008
Last updated
11/21/2024
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