Provider Demographics
NPI:1346444742
Name:CAPPS, RAYMOND LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LEE
Last Name:CAPPS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1106 HOSPITAL ROAD
Mailing Address - Street 2:NEUROSCIENCE CENTER
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6742
Mailing Address - Country:US
Mailing Address - Phone:850-863-8100
Mailing Address - Fax:850-863-7045
Practice Address - Street 1:1106 HOSPITAL ROAD
Practice Address - Street 2:NEUROSCIENCE CENTER
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6742
Practice Address - Country:US
Practice Address - Phone:850-863-8100
Practice Address - Fax:850-863-7045
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2016-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD300442084N0400X
FLME1301342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND29081Medicare UPIN
TN3726745Medicare ID - Type UnspecifiedMEDICARE