Individual
GEORGE SAMUEL DEEPE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 584-6868
(513) 584-6040
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-044441
OH
207RI0200X
Infectious Disease Physician
Primary
35-044441
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495950
—
OH
05
—
200271720
—
IN
05
—
64781362
—
KY
Enumeration date
04/20/2006
Last updated
08/09/2017
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