MEDICARE: PATRIZIO CAPASSO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	36104533	IL
2	2085R0204X	Vascular & Interventional Radiology Physician	42595	KY
3	2085R0202X	Diagnostic Radiology Physician	42595	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306803192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRIZIO CAPASSO MD

Provider Business Mailing Address
First Line	:	3621 BARROW WOOD LN
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-6107
Country	:	US
Telephone Number	:	702-234-7430
Fax Number	:

Provider Business Practice Location Address
First Line	:	3621 BARROW WOOD LN
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-6107
Country	:	US
Telephone Number	:	702-234-7430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	12/03/2012

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Directions to “ PATRIZIO CAPASSO MD” Practice Location

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