Provider Demographics
NPI:1932590619
Name:DEPREY, JAMES
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:DEPREY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4295 GROLL RD
Mailing Address - Street 2:
Mailing Address - City:WALDO
Mailing Address - State:OH
Mailing Address - Zip Code:43356-9119
Mailing Address - Country:US
Mailing Address - Phone:740-815-3558
Mailing Address - Fax:
Practice Address - Street 1:4295 GROLL RD
Practice Address - Street 2:
Practice Address - City:WALDO
Practice Address - State:OH
Practice Address - Zip Code:43356-9119
Practice Address - Country:US
Practice Address - Phone:740-815-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications