Provider Demographics
NPI:1245307990
Name:CAPUY, HALBERT C (MD)
Entity type:Individual
Prefix:
First Name:HALBERT
Middle Name:C
Last Name:CAPUY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2467 GOLDEN CAMP RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-5515
Mailing Address - Country:US
Mailing Address - Phone:706-790-4440
Mailing Address - Fax:706-790-4393
Practice Address - Street 1:1111 GARREDD BLVD STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6751
Practice Address - Country:US
Practice Address - Phone:706-863-5776
Practice Address - Fax:706-868-7057
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA022925208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00456761AMedicaid
GA00456761CMedicaid