Provider Demographics
NPI:1093906281
Name:KAPOOR, KAPIL GOPAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAPIL
Middle Name:GOPAL
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 KEMPSVILLE CIR STE 250B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3933
Mailing Address - Country:US
Mailing Address - Phone:757-481-4400
Mailing Address - Fax:757-481-1285
Practice Address - Street 1:6160 KEMPSVILLE CIR STE 120B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3933
Practice Address - Country:US
Practice Address - Phone:757-481-4400
Practice Address - Fax:757-481-1285
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253797207WX0107X, 207W00000X
MN54466207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
MNENROLLEDMedicaid
VA1093906281Medicaid
NC1093906281Medicaid
MNENROLLEDMedicaid
MNP00992436OtherMEDICARE RAILROAD
MNENROLLEDMedicaid
NCNCM950E517OtherMEDICARE PTAN
MNP01051982OtherMEDICARE RAILROAD
IAENROLLEDMedicaid