Individual
DR. JEFFREY GERARD DEPPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2720 S WASHINGTON AVE, SUITE 300, LANSING, MI 48910-2873
(517) 487-8255
(517) 487-2059
Mailing address
2720 S WASHINGTON AVE, SUITE 300, LANSING, MI 48910-2873
(517) 487-8255
(517) 487-2059
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101014681
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020C311510
BCBSM
MI
01
—
1015391
MCLAREN HEALTH PLAN
MI
01
—
200000001870
PHP MEDICAID
MI
05
—
4748047
—
MI
01
—
53311215
BCBSM
MI
01
—
CA3383
RAILROAD MEDICARE
MI
Enumeration date
07/27/2005
Last updated
04/20/2010
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