SAMUEL DALTON CAPOUCH

SPRINGFIELD, IL
NPI1326501750
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: IL  036164600)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-04-11
Last Update Date2023-10-06
Business Address
SAMUEL DALTON CAPOUCH MD
301 N 8TH ST
SPRINGFIELD, IL 62701-1041
Phone number: 217-528-7541
Mailing Address
SAMUEL DALTON CAPOUCH MD
PO BOX 19248
SPRINGFIELD, IL 62794-9248
Phone number: 217-528-7541