Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deaconess Clinc Inc

Organization Dermatology Physician · NPI 1053077107

Deaconess Clinc Inc is a Dermatology Physician in Madisonville, Kentucky. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1851 N Main St
Madisonville, KY 42431-9024
Phone: (812) 450-6859
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1053077107
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cheryl Wathen — Cfo · (812) 450-3296
Other names Deaconess Clinic Dermatology Madisonville
NPI enumeratedNovember 12, 2021
Last updated in NPPESNovember 12, 2021
Certification dateNovember 12, 2021
Mailing addressPo Box 1510, Evansville, IN 47706-1510

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