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Organization
CAPRI MEDICAL CENTER
Active
Organization
CAPRI MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLIE ROUSE MD (CO-PRESIDENT)
(678) 621-4715
Entity
Organization
Contact information
Practice address
9280 HIGHWAY 5 STE A, DOUGLASVILLE, GA 30134-1501
(770) 726-8988
(470) 689-3325
Mailing address
9280 HIGHWAY 5 STE A, DOUGLASVILLE, GA 30134-1501
(770) 726-8988
(470) 689-3325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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