Healthcare Provider Details
I. General information
NPI: 1235796525
Provider Name (Legal Business Name): JOSEPH PAUL CASTLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2019
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US
IV. Provider business mailing address
PO BOX 778912
CHICAGO IL
60677-8912
US
V. Phone/Fax
- Phone: 317-948-2700
- Fax:
- Phone: 317-777-6435
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 01093421A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | 01093421A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: