Provider Demographics
NPI:1295808319
Name:CAPPS, DWIGHT H (MD)
Entity type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:H
Last Name:CAPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 505E
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-753-3131
Mailing Address - Fax:270-753-3169
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 505E
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-753-3131
Practice Address - Fax:270-753-3169
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY34843207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY180035750OtherRR MEDICARE
KY000000047706OtherANTHEM PIN
KY64384340Medicaid
KY64384340Medicaid
KY0209410Medicare PIN
B89946Medicare UPIN
KY000000047706OtherANTHEM PIN