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General NPI Number Information
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NPI Number | 1710931613
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Entity Type | Individual
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Provider Name | TODD CAPISTRANT D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1001 NOBLE ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-4922
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Country | US
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Telephone | 907-458-2682
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Fax | 907-458-2628
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Provider Business Mailing Address
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Address Line | 1001 NOBLE ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-4922
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Country | US
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Telephone | 907-459-3500
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Fax | 907-458-2628
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5183
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 5183
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License Number State | AK
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