Healthcare Provider Details

I. General information

NPI: 1093785032
Provider Name (Legal Business Name): THEODORE H CAPRON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 DANIEL WEBSTER HWY
MEREDITH NH
03253-5803
US

IV. Provider business mailing address

PO BOX 1327
LACONIA NH
03247-1327
US

V. Phone/Fax

Practice location:
  • Phone: 603-279-7464
  • Fax: 603-279-8467
Mailing address:
  • Phone: 603-524-3211
  • Fax: 603-527-7038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7074
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0057938
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: