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General NPI Number Information
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NPI Number | 1255691713
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Entity Type | Individual
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Provider Name | SIMRAN SHASHI KAPUR M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1171 W TARGET RANGE RD
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City | NOGALES
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State | AZ
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Zip | 85621-2415
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Country | US
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Telephone | 520-285-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 305 W JACKSON ST SUITE 200
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City | CARBONDALE
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State | IL
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Zip | 62901-1474
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Country | US
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Telephone | 618-536-6621
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Fax | 618-453-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 51003
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01073627A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125-060331
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License Number State | IL
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