Depersio, Kenneth P

Depersio, Kenneth P is an individual health care provider with primary practice located at 100 Doctors Dr Ste F , Douglas GA 31533-2211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Depersio, Kenneth P can be contacted via phone (912) 383-6575.

Contact Information

Primary practice address
100 Doctors Dr Ste F Douglas GA 31533-2211
Phone: (912) 383-6575
Fax: (912) 383-6476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 053329 Georgia

Profile Details

NPI number 1437125812
LBN Legal business name Depersio, Kenneth P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437125812 NPPES
Georgia Other 341176 WELLCARE OF GEORGIA
Georgia MEDICAID 904817618C WELLCARE OF GEORGIA
Georgia MEDICAID 904817618D WELLCARE OF GEORGIA
Georgia Other 956500 WELLCARE OF GEORGIA
Georgia Other 205778734002 WELLCARE OF GEORGIA
Georgia Other GRP7930 WELLCARE OF GEORGIA
Georgia Other P00127268 WELLCARE OF GEORGIA
Georgia Other 053329 WELLCARE OF GEORGIA
Georgia Other 053329 WELLCARE OF GEORGIA

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