| NPI | 1053077107 |
|---|---|
| Doing Business As | DEACONESS CLINIC DERMATOLOGY MADISONVILLE |
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2021-11-12 |