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NPI Code Detail

MEDICARE: DR. TIMOTHY WAYNE CAPPS M.D.

MEDICARE: DR. TIMOTHY WAYNE CAPPS M.D.
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
1208600000XSurgery Physician2015-00935NC

General Provider Information

NPI Number : 1801025135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY WAYNE CAPPS M.D.
Provider Business Mailing Address
First Line : 1177 N ROAD ST
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-3388
Country : US
Telephone Number : 252-337-9440
Fax Number : 252-384-9997
Provider Business Practice Location Address
First Line : 1177 N ROAD ST
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-3388
Country : US
Telephone Number : 252-337-9440
Fax Number : 252-384-9997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 04/23/2021

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