Healthcare Provider Details

I. General information

NPI: 1841303484
Provider Name (Legal Business Name): DEACONESS HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 FREDERICA ST STE 1003
OWENSBORO KY
42301-3075
US

IV. Provider business mailing address

PO BOX 1230
EVANSVILLE IN
47706-1230
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-8984
  • Fax: 270-689-0054
Mailing address:
  • Phone: 812-450-6815
  • Fax: 812-450-6822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: LINDA E WHITE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 812-450-5000