Provider Demographics
NPI:1346209574
Name:CAPPIELLO, RICHARD ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLAN
Last Name:CAPPIELLO
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:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-0130
Mailing Address - Country:US
Mailing Address - Phone:970-858-2186
Mailing Address - Fax:970-858-2208
Practice Address - Street 1:576 KOKOPELLI BLVD UNIT D
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-6306
Practice Address - Country:US
Practice Address - Phone:970-858-2590
Practice Address - Fax:970-858-5036
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0057964207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
660004040OtherMEDICARE RAILROAD
FLE46865Medicare UPIN
FL07279SMedicare ID - Type Unspecified