Deaconess Clinic I

LBN: Deaconess Clinc Inc
Deaconess Clinic I is an health care organization with primary practice located at 813 E 4Th St Ste A , Mount Vernon IN 47620-2012. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is the primary health care specialty. Deaconess Clinc Inc can be contacted via phone (812) 838-2139, or through Wathen, Cheryl A via phone (812) 450-3296.

Contact Information

Primary practice address
813 E 4Th St Ste A Mount Vernon IN 47620-2012
Phone: (812) 838-2139
Fax: (812) 838-9214
Website:
Map and Directions
Authorized official contact:
Name: Wathen, Cheryl A
Phone: (812) 450-3296

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1609108976
LBN Legal business name Deaconess Clinc Inc
DBA Doing business as Deaconess Clinic I
Authorized official Wathen, Cheryl A
Entity Organization
Organization subpart 1 No
Enumeration date Feb 11th, 2010
Last updated Oct 27th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609108976 NPPES
Indiana MEDICAID 200910700

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