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NPI Code Detail

MEDICARE: RICHARD CAPO PA-C

MEDICARE: RICHARD CAPO PA-C
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
1363A00000XPhysician Assistant0010-04639NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10010-04639OTHERNCNC MEDICAL LICENSE

General Provider Information

NPI Number : 1730178880
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CAPO PA-C
Provider Business Mailing Address
First Line : 8320 E WALKER SPRINGS LN STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3120
Country : US
Telephone Number : 865-769-4500
Fax Number : 865-769-4501
Provider Business Practice Location Address
First Line : 1422 OLD WEISGARBER RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1293
Country : US
Telephone Number : 865-558-4400
Fax Number : 865-558-4421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 01/14/2026

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