NPI age
20 years
Enumerated 2006-02-27
● Active
Type 1 · Individual
DR. Kenneth P Depersio, MD
Depersio is 1 of 10 orthopaedic surgery providers in Douglas and 1 of 1151 in Georgia.
Primary specialty
Orthopaedic Surgery
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1151 active orthopaedic surgery providers in Georgia.
NPI age
20 years
↑ 2 yr above median (18 yr)
State licenses
1 state
14% of peers hold multiple states
Subspecialties
0
33% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-02Enumerated in NPPES
2006
2026
Where they practice
Practice location
100 Doctors Dr Ste F
Douglas, GA 315332211
Mailing address
100 Doctors Dr Ste I
Douglas, GA 315332211
Specialties
-
Orthopaedic Surgery PrimaryAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 341176 | WELLCARE OF GEORGIA |
| 05 (GA) | 904817618C | |
| 05 (GA) | 904817618D | |
| 01 (GA) | 956500 | BCBS |
| 01 | 205778734002 | TRICARE |
| 01 (GA) | GRP7930 | MEDICARE GROUP # EFFECTIVE 02/01/2008 |
| 01 (GA) | P00127268 | RAILROAD MEDICARE |
| 01 (GA) | 053329 | MEDICAL LICENSE |
| 01 (GA) | 053329 | GA LICENSE |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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