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
4133 GATEWAY BLVD, 2ND FLOOR, NEWBURGH, IN 47630-7918
(812) 853-5671
(812) 853-5697
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 853-5671
(812) 853-5697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/18/2008
Last updated
08/10/2017
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