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General NPI Number Information
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NPI Number | 1396768537
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Entity Type | Organization
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Legal Business Name | DEACONESS MEMORIAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 800 W 9TH ST
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City | JASPER
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State | IN
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Zip | 47546-2514
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Country | US
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Telephone | 812-482-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W 9TH ST
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City | JASPER
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State | IN
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Zip | 47546-2514
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Country | US
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Telephone | 812-481-8483
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Fax | 812-481-8497
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Authorized Official
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Title or Position | CAO & INDIANA REGION PRESIDENT
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Name | MR. KEITH MILLER
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Credential |
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Telephone | 812-996-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation 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 | 2084P0800X
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Taxonomy Name | Psychiatry 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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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