Healthcare Provider Details

I. General information

NPI: 1710994132
Provider Name (Legal Business Name): EUGENIO CASTILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 N DAL PASO ST STE A
HOBBS NM
88240-3023
US

IV. Provider business mailing address

1600 NORTH MAIN NOR-LEA HOSPITAL DISTRICT
LOVINGTON NM
88260-2830
US

V. Phone/Fax

Practice location:
  • Phone: 575-443-3000
  • Fax: 575-396-1454
Mailing address:
  • Phone: 575-396-6611
  • Fax: 575-396-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number87-351
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number87-351
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: