Healthcare Provider Details

I. General information

NPI: 1609848860
Provider Name (Legal Business Name): THOMAS ANTHONY CAPOZZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 PLEASANT ST BLDG 4, SUITE 501
FALL RIVER MA
02721-3005
US

IV. Provider business mailing address

289 PLEASANT ST BLDG 4, SUITE 501
FALL RIVER MA
02721-3005
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-6611
  • Fax: 508-679-1218
Mailing address:
  • Phone: 508-679-6611
  • Fax: 508-679-1218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number230572
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number230572
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: