Kenneth P Depersio (NPI# 1437125812, PAC ID# 1254328552) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1437125812 |
| PAC ID by PECOS | 1254328552 |
| Professional Enrollment ID | I20040428001180 |
| Full Name | Kenneth P Depersio |
| Organization Legal Name | ORTHOPEDIC SURGEONS OF GEORGIA LLC |
| Address |
100 Doctors Dr Douglas GA 31533-2211 |
| Phone Number | 9123836575 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 1974 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 5597939421 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110089 | COFFEE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 Doctors Dr, Douglas, GA 31533-2211 | 9123836575 | ORTHOPEDIC SURGEONS OF GEORGIA LLC |
| Organization Legal Name | ORTHOPEDIC SURGEONS OF GEORGIA LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gabrielle A. O'berry | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Suite I, Douglas, GA 31533-2211 |
| Hewatt M Sims | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Vicy Carroll | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Laura Liles Tharp | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Stephen Augustine | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Joshua Hughes | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Joshua Landon Vickers | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| William E Macleod | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Street Address |
100 DOCTORS DR |
| City | DOUGLAS |
| State | GA |
| Zip | 31533-2211 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gabrielle A. O'berry | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Suite I, Douglas, GA 31533-2211 |
| Tim M Smith | General Practice | 100 Doctors Dr, Suite A, Panama City, FL 32405-7609 | |
| Hewatt M Sims | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Vicy Carroll | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Laura Liles Tharp | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Debbie Regina Purvis | Nurse Practitioner | Crh Physician Practices, LLC | 100 Doctors Dr, Suite G, Douglas, GA 31533-2211 |
| Stephen Augustine | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Joshua Hughes | Nurse Practitioner | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Joshua Landon Vickers | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| William E Macleod | Orthopedic Surgery | Orthopedic Surgeons of Georgia LLC | 100 Doctors Dr, Douglas, GA 31533-2211 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Henry Randall Sheffield | Chiropractic | 410 Ward E St, Douglas, GA 31533-0001 | |
| Heather Cason Carver | Registered Dietitian Or Nutrition Professional | 204 Gaskin Ave N, Douglas, GA 31533-0400 | |
| Thaihang Nguyen | Family Medicine | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Stephen R Miller | Physical Therapy | 1150 W Ward St Extension, Suite B1, Douglas, GA 31533-1902 | |
| Chester Theo Royals Jr. | General Surgery | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Joel W Ferree | Cardiovascular Disease (cardiology) | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Alfred W Mazur | Urology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Jesse Allen Kane | Obstetrics/gynecology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Kimberly E Lott | Physician Assistant | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Amanda Bice | Nurse Practitioner | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
| Find all physicians in zip 31533 | |||
| City | DOUGLAS |
| Zip Code | 31533 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | DOUGLAS + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Kenneth P Depersio.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.