Organization
DEACONESS BREAST CENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL W. WHITEHEAD M.D. (BOARD OF DIRECTORS)
(812) 422-3254
Entity
Organization
Contact information
Practice address
520 MARY ST, SUITE 140, EVANSVILLE, IN 47710-1677
(812) 424-1200
(812) 424-4163
Mailing address
520 MARY ST, SUITE 140, EVANSVILLE, IN 47710-1677
(812) 424-1200
(812) 424-4163
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI6801
RAILROAD MEDICARE
IN
Enumeration date
10/04/2005
Last updated
02/21/2008
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