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General NPI Number Information
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NPI Number | 1376799213
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Entity Type | Organization
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Legal Business Name | DEACONESS CLINIC, INC
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 4209 GATEWAY BLVD
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City | NEWBURGH
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State | IN
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Zip | 47630-8900
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Country | US
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Telephone | 812-853-5300
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Fax | 812-858-4660
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Provider Business Mailing Address
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Address Line | PO BOX 1510
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City | EVANSVILLE
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State | IN
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Zip | 47706-1510
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Country | US
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Telephone | 812-853-5300
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Fax | 812-858-4660
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Authorized Official
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Title or Position | CFO
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Name | CHERYL A WATHEN
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Credential |
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Telephone | 812-450-3296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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