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NPI Code Detail

MEDICARE: DEACONESS HOSPITAL, INC

MEDICARE: DEACONESS HOSPITAL, 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
1363L00000XNurse Practitioner
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2CG1119OTHERINRR MCARE GROUP #

General Provider Information

NPI Number : 1336152156
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEACONESS HOSPITAL, INC
Provider Business Mailing Address
First Line : PO BOX 3407
Second Line :
City : EVANSVILLE
State : IN
Zip : 47733-3407
Country : US
Telephone Number : 812-450-6815
Fax Number : 812-450-6822
Provider Business Practice Location Address
First Line : 8600 UNIVERSITY BLVD
Second Line : RM HP0091
City : EVANSVILLE
State : IN
Zip : 47712-3534
Country : US
Telephone Number : 812-465-1250
Fax Number : 812-465-7170
Authorized Official
Title or Position : PRESIDENT & CEO
Name : LINDA E WHITE
Credential :
Telephone Number : 812-450-2250
Provider Enumeration Date : 08/14/2006
Last Update Date : 09/01/2010

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Practice Location Address:
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1891797007 — RICHARD A RIEDFORD M.D.
Practice Location Address:
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1508932930 — VERNON PAUL BANNING MD
Practice Location Address:
8600 UNIVERSITY BLVD , RM HP0091
EVANSVILLE, IN
47712-3534
Practice Phone: 812-465-1250
Practice Fax: 812-465-7170
1609934769 — PHILIP A WUERTZ LCSW
Practice Location Address:
8600 UNIVERSITY BLVD , RM HP0091
EVANSVILLE, IN
47712-3534
Practice Phone: 812-465-1250
Practice Fax: 812-465-7170
1013200930 — MELISSA L ATTEBURY NP
Practice Location Address:
8600 UNIVERSITY BLVD RM HP0091
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1093000283 — DEACONESS CLINIC INC
Practice Location Address:
8600 UNIVERSITY BLVD , ROOM HP0091
EVANSVILLE, IN
47712-3534
Practice Phone: 812-465-1250
Practice Fax: 812-465-7170

Directions to “DEACONESS HOSPITAL, INC ” Practice Location

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