Provider Demographics
NPI:1568552297
Name:CAPPS, STEPHEN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:CAPPS
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 1:630 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4206
Mailing Address - Country:US
Mailing Address - Phone:828-693-0747
Mailing Address - Fax:828-693-0947
Practice Address - Street 1:630 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4206
Practice Address - Country:US
Practice Address - Phone:828-693-0747
Practice Address - Fax:828-693-0947
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL7761R207W00000X
NC2012-02008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5922416Medicaid
LA1927112Medicaid
LA0435280002Medicare NSC
NC5922416Medicaid
E65825Medicare UPIN
LA1927112Medicaid
LA5N334B612Medicare PIN