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Organization

DEACONESS MEMORIAL MEDICAL CENTER, INC

Active
Parent organization
DEACONESS MEMORIAL MEDICAL CENTER
Other names
Loogootee Family Medicine
Organization subpart
Yes

Provider details

NPI number
Legal business name
DEACONESS MEMORIAL MEDICAL CENTER
Authorized official
KEITH MILLER (CAO & INDIANA REGION PRESIDENT)
(812) 996-0507
Entity
Organization

Contact information

Practice address
105 COOPER ST, LOOGOOTEE, IN 47553
(812) 295-2812
(812) 295-3726
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
261QR1300X
Rural Health Clinic/Center
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200048850E
IN
01
CB3118
RAILROAD MEDICARE
IN
Enumeration date
10/16/2006
Last updated
03/16/2026
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