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DR. KENNETH P DEPERSIO MD NPI 1437125812


NPI Information

NPI: 1437125812
Provider Name: DR. KENNETH P DEPERSIO, MD
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual
Address:
100 DOCTORS DR STE F
DOUGLAS, GA
ZIP 31533
Phone: (912) 383-6575
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DR. Kenneth P Depersio, MD is an orthopaedic surgery in Douglas, GA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Kenneth P Depersio, MD NPI is 1437125812. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 DOCTORS DR STE F
DOUGLAS, GA
ZIP 31533-211
Phone: (912) 383-6575
Fax: (912) 383-6476

The enumeration date for this NPI number is 2/27/2006 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery053329GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1341176OTHERGEORGIAWELLCARE OF GEORGIA
2904817618CMEDICAIDGEORGIA
3904817618DMEDICAIDGEORGIA
4956500OTHERGEORGIABCBS
5205778734002OTHERTRICARE
6GRP7930OTHERGEORGIAMEDICARE GROUP # EFFECTIVE 02/01/2008
7P00127268OTHERGEORGIARAILROAD MEDICARE
8053329OTHERGEORGIAMEDICAL LICENSE
9053329OTHERGEORGIAGA LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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