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General NPI Number Information
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NPI Number | 1659893139
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Entity Type | Organization
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Legal Business Name | JAMES B DEPEW MD PC
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 3333 OLD MILTON PKWY STE 260
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City | ALPHARETTA
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State | GA
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Zip | 30005-4626
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Country | US
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Telephone | 770-772-0695
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Fax | 877-592-3455
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Provider Business Mailing Address
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Address Line | 120 VANN ST NE STE 150
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City | MARIETTA
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State | GA
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Zip | 30060-7358
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Country | US
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Telephone | 770-421-1242
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Fax | 770-424-6652
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Authorized Official
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Title or Position | PLASTIC SURGEON / OWNER
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Name | DR. JAMES BRADFORD DEPEW
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Credential | MD FACS
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Telephone | 804-301-6168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 078473
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License Number State | GA
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