Deaconess Clinic, Inc
Organization Active NPI Hematology & Oncology Physician · Evansville, IN
NPI 1053558841 · NPPES record last updated Jan 11, 2013
Key facts
- NPI
- 1053558841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- DEACONESS CLINIC, INC
- Practice address
- 611 Harriet St
Suite L-100
Evansville, IN 47710-1781 - Phone
- (812) 426-9411
- Fax
- (812) 426-9503
- NPI assigned
- Jan 15, 2009
- Organization subpart
- No
Authorized official
- Name
- Linda E White
- Title
- President/Ceo
- Phone
- (812) 450-2250
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080922000145 | IN | Part B Supplier - Clinic/Group Practice | 3375610116 |
Receives reassigned benefits from 477 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
611 Harriet St
Ste L100
Evansville, IN 47710
Phone (812) 421-6080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes | ||
| Acute Care Nurse Practitioner |
363LA2100X |
Addresses
Primary practice location
611 Harriet St
Suite L-100
Evansville, IN 47710-1781
Mailing address
PO Box 3868
Evansville, IN 47737-3868
Phone (812) 426-9411
Other names
- Deaconess Clinic II
Other providers in Evansville, IN
- Deaconess Clinic Inc.
- Deaconess Clinic Inc.
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
All providers in Evansville, IN · Hematology & Oncology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.