# CAPRI MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871394841
- **Authorized official:** DR. CHARLIE ROUSE MD (CO-PRESIDENT)
- **Authorized official phone:** (678) 621-4715

## Contact information

- **Practice address:** 9280 HIGHWAY 5 STE A, DOUGLASVILLE, GA 30134-1501
- **Practice address phone:** (770) 726-8988
- **Practice address fax:** (470) 689-3325
- **Mailing address:** 9280 HIGHWAY 5 STE A, DOUGLASVILLE, GA 30134-1501
- **Mailing address phone:** (770) 726-8988
- **Mailing address fax:** (470) 689-3325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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