Provider Demographics
NPI:1730348103
Name:DEPPISCH, HANNAH GRUBB (MD)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:GRUBB
Last Name:DEPPISCH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4800 NE STALLINGS DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1250
Mailing Address - Country:US
Mailing Address - Phone:936-205-9820
Mailing Address - Fax:936-205-9819
Practice Address - Street 1:4800 NE STALLINGS DR
Practice Address - Street 2:SUITE 115
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1250
Practice Address - Country:US
Practice Address - Phone:936-205-9820
Practice Address - Fax:936-205-9819
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2015-09-02
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Provider Licenses
StateLicense IDTaxonomies
TXN3611207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine