Provider Demographics
NPI:1487762621
Name:CAPEL, STEVE DAVID (PT)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:DAVID
Last Name:CAPEL
Suffix:
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 1:239 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:TN
Mailing Address - Zip Code:37185-1629
Mailing Address - Country:US
Mailing Address - Phone:931-296-3400
Mailing Address - Fax:931-296-3481
Practice Address - Street 1:239 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:TN
Practice Address - Zip Code:37185-1629
Practice Address - Country:US
Practice Address - Phone:931-296-3400
Practice Address - Fax:931-296-3481
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000005631174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3652156Medicare UPIN