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
106 W PIKE AVE, PETERSBURG, IN 47567-8750
(812) 354-1052
(812) 354-8280
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 354-1052
(812) 354-8280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/12/2008
Last updated
08/10/2017
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