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NPI Code Detail

MEDICARE: DEACONESS CLINIC, INC.

MEDICARE: DEACONESS CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist
2207RG0100XGastroenterology Physician
3363L00000XNurse Practitioner
4207Y00000XOtolaryngology Physician

General Provider Information

NPI Number : 1558766790
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEACONESS CLINIC, INC.
Provider Business Mailing Address
First Line : PO BOX 631767
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-1767
Country : US
Telephone Number : 812-450-6815
Fax Number : 812-450-6822
Provider Business Practice Location Address
First Line : 1808 SHERMAN DR
Second Line :
City : PRINCETON
State : IN
Zip : 47670-1043
Country : US
Telephone Number : 812-425-2646
Fax Number : 812-858-4586
Authorized Official
Title or Position : CFO
Name : CHERYL A WATHEN
Credential :
Telephone Number : 812-450-3296
Provider Enumeration Date : 10/30/2014
Last Update Date : 02/26/2026

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Directions to “DEACONESS CLINIC, INC. ” Practice Location

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