Provider Demographics
NPI:1083061717
Name:CAPPS, DENISE ELIZABETH (MD)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ELIZABETH
Last Name:CAPPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 E ST LUKES ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7833
Mailing Address - Country:US
Mailing Address - Phone:208-288-2020
Mailing Address - Fax:
Practice Address - Street 1:3045 E ST LUKES ST STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7833
Practice Address - Country:US
Practice Address - Phone:208-288-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA322470207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology