Provider Demographics
NPI:1457870768
Name:CAPERTON FERTILITY INSTITUTE, PLLC
Entity Type:Organization
Organization Name:CAPERTON FERTILITY INSTITUTE, PLLC
Other - Org Name:CAPERTON FERTILITY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPERTON
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:505-702-8020
Mailing Address - Street 1:6500 JEFFERSON ST NE STE 250
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3490
Mailing Address - Country:US
Mailing Address - Phone:505-702-8020
Mailing Address - Fax:505-796-8022
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5002
Practice Address - Country:US
Practice Address - Phone:915-600-2220
Practice Address - Fax:915-600-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty