Provider Demographics
NPI:1861791592
Name:CAPERTON, CAROLINE VIRGINIA (MD, MSPH)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:VIRGINIA
Last Name:CAPERTON
Suffix:
Gender:F
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 BERT KOUNS INDUSTRIAL LOOP STE 112
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3153
Mailing Address - Country:US
Mailing Address - Phone:318-212-4824
Mailing Address - Fax:
Practice Address - Street 1:2530 BERT KOUNS INDUSTRIAL LOOP STE 112
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3153
Practice Address - Country:US
Practice Address - Phone:318-212-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55107207K00000X
CA1240-A128853207K00000X
LA305331207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology