Organization
DEACONESS SPECIALITY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CREDENTIALING SPECIALIST)
(812) 450-3296
Entity
Organization
Contact information
Practice address
120 SE 4TH ST, EVANSVILLE, IN 47708-1607
(812) 426-6638
(812) 858-6802
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/16/2021
Last updated
09/30/2024
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