Provider Demographics
NPI:1841483666
Name:CAPLIS, CHARLES ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANTHONY
Last Name:CAPLIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 N HALSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3105
Mailing Address - Country:US
Mailing Address - Phone:228-818-2801
Mailing Address - Fax:228-818-2803
Practice Address - Street 1:999 N HALSTEAD RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3105
Practice Address - Country:US
Practice Address - Phone:228-818-2801
Practice Address - Fax:228-818-2803
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005304213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1145521Medicaid
IL202898001Medicare PIN