Healthcare Provider Details

I. General information

NPI: 1245279751
Provider Name (Legal Business Name): JOHN B CASTERLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2871 ACTON ROAD SUITE 100
BIRMINGHAM AL
35243-2560
US

IV. Provider business mailing address

2871 ACTON ROAD SUITE 100
BIRMINGHAM AL
35243-2560
US

V. Phone/Fax

Practice location:
  • Phone: 205-716-6900
  • Fax: 205-939-0293
Mailing address:
  • Phone: 205-939-0023
  • Fax: 205-939-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number17130
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: