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Individual

JOHN W. DEPPE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Mailing address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
1033356
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000108319
ANTHEM
IN
01
200308
HEALTHLINK
IN
Enumeration date
07/07/2005
Last updated
07/08/2007
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