Provider Demographics
NPI:1194733519
Name:DEPPER, JOEL MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MICHAEL
Last Name:DEPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1250 NE 3RD ST
Mailing Address - Street 2:SUITE B-100
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4331
Mailing Address - Country:US
Mailing Address - Phone:541-317-1700
Mailing Address - Fax:541-317-1777
Practice Address - Street 1:1250 NE 3RD ST
Practice Address - Street 2:SUITE B-100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4331
Practice Address - Country:US
Practice Address - Phone:541-317-1700
Practice Address - Fax:541-317-1777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR18914207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy