Provider Demographics
NPI:1841260486
Name:CAPPS, JAMES LOUIS III (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LOUIS
Last Name:CAPPS
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824
Mailing Address - Country:US
Mailing Address - Phone:706-595-9445
Mailing Address - Fax:706-595-0029
Practice Address - Street 1:431 WEST HILL STREET
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824
Practice Address - Country:US
Practice Address - Phone:706-595-9445
Practice Address - Fax:706-595-0029
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00812996AMedicaid
GA23688429AMedicare ID - Type Unspecified
GA00812996AMedicaid