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Individual

DR. JOHN D. DEPERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
146 E HOSPITAL DR STE 400, WEST COLUMBIA, SC 29169-4800
(803) 936-3300
(803) 936-7735
Mailing address
3627 UNIVERSITY BLVD S, SUITE 700, JACKSONVILLE, FL 32216-4230
(904) 399-5678
(904) 399-8488

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
86833
SC
208600000X
Surgery Physician
Primary
ME79425
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004359200
FL
01
278558
AVMED
01
51834
BCBS FL
01
6427217
CIGNA
01
7528092
AETNA
01
P00062696
RAILROAD MEDICARE
Enumeration date
05/03/2006
Last updated
01/12/2024
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