Healthcare Provider Details

I. General information

NPI: 1093906281
Provider Name (Legal Business Name): KAPIL GOPAL KAPOOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 KEMPSVILLE CIR STE 120B
NORFOLK VA
23502-3933
US

IV. Provider business mailing address

6160 KEMPSVILLE CIR STE 250B
NORFOLK VA
23502-3933
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-4400
  • Fax: 757-481-1285
Mailing address:
  • Phone: 757-481-4400
  • Fax: 757-481-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number0101253797
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101253797
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: