Healthcare Provider Details

I. General information

NPI: 1366421208
Provider Name (Legal Business Name): RICHARD H CAPPS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 FAIRWAY CIR NE
BROOKHAVEN GA
30319-3873
US

IV. Provider business mailing address

793 SAWYER RD
MARIETTA GA
30062-2222
US

V. Phone/Fax

Practice location:
  • Phone: 470-785-7499
  • Fax: 470-222-2705
Mailing address:
  • Phone: 470-785-7499
  • Fax: 470-222-2705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number87488
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200001084
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: