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Organization

DEACONESS CLINIC, INC

Active
Other names
Deaconess Comp Center Gateway
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA E WHITE (PRESIDENT & CEO)
(812) 450-2250
Entity
Organization

Contact information

Practice address
4011 GATEWAY BLVD STE 100, NEWBURGH, IN 47630-8947
(812) 858-2100
(812) 858-2120
Mailing address
PO BOX 3366, EVANSVILLE, IN 47732-3366
(812) 450-7455
(812) 450-2960

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
261QX0100X
Occupational Medicine Clinic/Center
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200191200B
IN
Enumeration date
05/04/2006
Last updated
01/14/2022
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