Healthcare Provider Details

I. General information

NPI: 1881197945
Provider Name (Legal Business Name): CAITLIN LEIGH CASTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 06/26/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88TH MEDICAL GROUP 4881 SUGAR MAPLE DR.
WRIGHT PATTERSON AIR FORCE BASE OH
45433
US

IV. Provider business mailing address

88TH MEDICAL GROUP 4881 SUGAR MAPLE DR.
WRIGHT PATTERSON AIR FORCE BASE OH
45433
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-1942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberS3955
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: