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NPI Code Detail

MEDICARE: ANDREA DERI CAPPS MAY OD

MEDICARE:   ANDREA DERI CAPPS MAY  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist001685GA

General Provider Information

NPI Number : 1740365428
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA DERI CAPPS MAY OD
Provider Business Mailing Address
First Line : PO BOX 511
Second Line :
City : GROVETOWN
State : GA
Zip : 30813-0511
Country : US
Telephone Number : 706-627-1547
Fax Number :
Provider Business Practice Location Address
First Line : 2435 COMMERCE AVE BLDG 2200
Second Line : SUITE B
City : DULUTH
State : GA
Zip : 30096-4980
Country : US
Telephone Number : 770-822-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 12/03/2025

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Directions to “ ANDREA DERI CAPPS MAY OD” Practice Location

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