Provider Demographics
NPI:1033110382
Name:DEPPE, JAMES TIMOTHY (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TIMOTHY
Last Name:DEPPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1155 W JEFFERSON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2730
Mailing Address - Country:US
Mailing Address - Phone:317-346-3883
Mailing Address - Fax:317-346-3141
Practice Address - Street 1:1155 W JEFFERSON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2730
Practice Address - Country:US
Practice Address - Phone:317-346-3883
Practice Address - Fax:317-346-3141
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01025133A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10040269DAMedicaid
D70852Medicare UPIN
IN10040269DAMedicaid