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DEACONESS CLINIC INC NPI 1205082583


NPI Information

NPI: 1205082583
Provider Name: DEACONESS CLINIC, INC

Doing Business As: DEACONESS CLINIC I

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D1086876

Address:
520 MARY ST
STE 340
EVANSVILLE, IN
ZIP 47710
Phone: (812) 450-6700
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DEACONESS CLINIC, INC is a family medicine in Evansville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DEACONESS CLINIC, INC NPI is 1205082583. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Clinic I.

The provider's business location address is:

520 MARY ST
STE 340
EVANSVILLE, IN
ZIP 47710-677
Phone: (812) 450-6700
Fax: (812) 450-6710

The provider's authorized official is Cheryl A Wathen .
The authorized official title is Cfo and has the following contact phone number (812) 450-3296.

The CLIA number assigned to this NPI record is 15D1086876 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/18/2008 and was last updated on 7/9/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalNo
2363A00000XPhysician AssistantNo
3207RH0002XInternal MedicineHospice and Palliative MedicineNo
4363L00000XNurse PractitionerNo
5363LA2100XNurse PractitionerAcute CareNo
6207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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