Organization Name: | JULIAN V CASTILLO JR PSC |
NPI Number: | 1861722910 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIAN V CASTILLO (PHYSICIAN) |
Mailing Address: | 1210 Ky Highway 36 E Suite G1 Cynthiana |
State: | KY US |
Postal Code: | 410317490 |
Phone Number: | 8592343314 |
Fax Number: | 8592343315 |
NPI Enumeration Date: | 01/12/2010 |
NPI Last Update Date: | 01/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |