Organization
DEACONESS HOSPITAL, INC
Active
Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Anesthesia Service at DCDT
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 450-2240
(812) 450-2710
Mailing address
PO BOX 3366, EVANSVILLE, IN 47732-3366
(812) 450-2240
(812) 450-2710
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200350410C
—
IN
01
—
234380
MEDICARE
IN
01
—
DE1201
RR MEDICARE
IN
Enumeration date
12/03/2014
Last updated
07/06/2017
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