Provider Demographics
NPI:1932128873
Name:CAPES, GEOFFREY GEORGE
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:GEORGE
Last Name:CAPES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4674 SNOW MESA DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528
Mailing Address - Country:US
Mailing Address - Phone:970-266-3650
Mailing Address - Fax:970-266-3660
Practice Address - Street 1:4674 SNOW MESA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528
Practice Address - Country:US
Practice Address - Phone:970-266-3650
Practice Address - Fax:970-266-3660
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-112286207R00000X, 208000000X
CODR.0048248208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036112286Medicaid
CO42727537Medicaid
IL036112286Medicaid
CO42727537Medicaid
K30018Medicare ID - Type Unspecified