Organization
DEACONESS SPECIALTY PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
721 W 13TH ST, JASPER, IN 47546-1855
(812) 996-7388
(812) 996-5933
Mailing address
PO BOX 632111, CINCINNATI, OH 45263-2111
(812) 450-6879
(812) 858-4586
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/14/2025
Last updated
10/22/2025
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