MEDICARE: DR. KEVIN CHARLES CAPP DO

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	207Q00000X	Family Medicine Physician	OT012782	PA
2	207Q00000X	Family Medicine Physician	OSO15055	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0266678	OTHER	PA	CIGNA
2	2538602	OTHER	PA	HIGHMARK BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588800155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN CHARLES CAPP DO

Provider Business Mailing Address
First Line	:	926 WEST 38TH STREET
Second Line	:	DR. KEVIN CAPP
City	:	ERIE
State	:	PA
Zip	:	16508
Country	:	US
Telephone Number	:	814-866-1960
Fax Number	:	814-866-1935

Provider Business Practice Location Address
First Line	:	95 S PARK ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1334
Country	:	US
Telephone Number	:	814-542-8627
Fax Number	:	814-542-5444

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

Provider Enumeration Date	:	12/31/2008
Last Update Date	:	06/06/2024

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