Provider Demographics
NPI:1194789040
Name:ERSKINE M CAPERTON MD PA
Entity type:Organization
Organization Name:ERSKINE M CAPERTON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERSKINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAPERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-633-6230
Mailing Address - Street 1:2233 HAMLINE AVE N
Mailing Address - Street 2:SUITE 508
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-5009
Mailing Address - Country:US
Mailing Address - Phone:651-633-6230
Mailing Address - Fax:651-633-2428
Practice Address - Street 1:2233 HAMLINE AVE N
Practice Address - Street 2:SUITE 508
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5009
Practice Address - Country:US
Practice Address - Phone:651-633-6230
Practice Address - Fax:651-633-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18800207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHEALTHPARTNERSOther200
MNPREFERRED ONEOther963940512001
RAILROAD MEDICAREOther11048626
MNU-CAREOther124693
MNAMERICA'S PPOOther24904
MNMEDICAOther3201887
MNPREFERRED ONEOther963940512001
MNHEALTHPARTNERSOther200