Individual
TIMOTHY J DECAPITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
167 N MAIN ST, TUBA CITY, AZ 86045
(928) 283-2501
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D68599
MD
Other
Enumeration date
02/15/2007
Last updated
10/26/2010
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