Healthcare Provider Details

I. General information

NPI: 1205880689
Provider Name (Legal Business Name): JAMES JOHN CASTLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W COUNTRY CLUB RD SUITE 130
ROSWELL NM
88201-5202
US

IV. Provider business mailing address

300 W COUNTRY CLUB RD SUITE 130
ROSWELL NM
88201-5240
US

V. Phone/Fax

Practice location:
  • Phone: 575-625-2669
  • Fax: 575-624-4599
Mailing address:
  • Phone: 575-625-2669
  • Fax: 575-624-4599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA-930-91
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA-930-91
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: