Individual
KELLY L CAPERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 CEDAR SE SUITE 507, PMG OB HOSPITALIST, ALBUQUERQUE, NM 87106
(505) 563-6381
(505) 563-6380
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
MD2005-0093
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93725035
—
NM
Enumeration date
11/17/2006
Last updated
08/15/2008
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