Healthcare Provider Details

I. General information

NPI: 1437131422
Provider Name (Legal Business Name): SCOTT A DEPPE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 MEADOWOOD LN
GREAT FALLS MT
59404-5616
US

IV. Provider business mailing address

3204 MEADOWOOD LN
GREAT FALLS MT
59404-5616
US

V. Phone/Fax

Practice location:
  • Phone: 269-615-2454
  • Fax:
Mailing address:
  • Phone: 269-615-2454
  • Fax: 406-866-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD60638958
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0442921
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101268966
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG9448
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number7889
License Number StateSD
# 6
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number68318
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: