Provider Demographics
NPI:1962952689
Name:CAPEL VASCULAR CENTER, LLC
Entity type:Organization
Organization Name:CAPEL VASCULAR CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL/VASCULAR/THORACIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-299-2501
Mailing Address - Street 1:408 E WASHINGTON ST
Mailing Address - Street 2:P.O. BOX 697
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-4539
Mailing Address - Country:US
Mailing Address - Phone:662-299-2501
Mailing Address - Fax:
Practice Address - Street 1:408 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-4539
Practice Address - Country:US
Practice Address - Phone:662-299-2501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS152992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty