Provider Demographics
NPI:1871561167
Name:CAPOCELLI, ANTHONY L JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:CAPOCELLI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 FAIR PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1720
Mailing Address - Country:US
Mailing Address - Phone:501-604-6900
Mailing Address - Fax:501-604-4167
Practice Address - Street 1:800 FAIR PARK BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1720
Practice Address - Country:US
Practice Address - Phone:501-604-6900
Practice Address - Fax:501-604-6941
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2162207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR18474000000OtherUNITED HEALTHCARE
AR136639001Medicaid
AR140007749OtherRAILROAD MEDICARE
AR5L165OtherARKANSAS BLUE CROSS
AR962562OtherUSA MCO
OK100007120AOtherOKLAHOMA MEDICAID
AR5L165OtherARKANSAS BLUE CROSS
AR136639001Medicaid