Organization · Type 2 NPI

Deaconess Memorial Medical Center Inc

Family Medicine Physician · Jasper, IN

NPI number 1104452200 Active

Practice location

695 W 2nd St Ste D
Jasper, IN 47546-3240

Call (812) 996-6330 Map

Fax (812) 996-6331

Mailing address

800 W 9th St
Jasper, IN 47546-2514

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: 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.

2 other providers at this address

Other family medicine physician providers in Jasper

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NPI record

NPI: 1104452200
Entity type: Organization (Type 2)
Issued: Mar 20, 2020
Last updated: Aug 27, 2025
Status: Active
Subpart: Yes of Deaconess Memorial Medical Center Inc

Other names

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Alternative Screening Site · doing business as
Alternative Screening Site · doing business as

Authorized official

Keith Miller
Cao & Indiana Region President
(812) 996-0507

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104452200

Deaconess Memorial Medical Center Inc's National Provider Identifier is 1104452200, issued on Mar 20, 2020. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Jasper, IN. The record was last updated on Aug 27, 2025.