Organization
DEACONESS MEMORIAL MEDICAL CENTER INC
Active
Parent organization
DEACONESS MEMORIAL MEDICAL CENTER INC
Other names
Memorial Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEACONESS MEMORIAL MEDICAL CENTER INC
Authorized official
MR. KEITH MILLER (CAO & INDIANA REGION PRESIDENT)
(812) 996-2345
Entity
Organization
Contact information
Practice address
751 W 9TH ST, JASPER, IN 47546-2609
(812) 996-0400
(812) 996-0653
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-8476
(812) 996-8497
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01062502A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200048850O
—
IN
01
—
CB3118
RAILROAD MEDICARE
IN
Enumeration date
08/15/2006
Last updated
08/27/2025
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