Healthcare Provider Details

I. General information

NPI: 1689799405
Provider Name (Legal Business Name): SHERRY J CASTILLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 HEATHROW WAY
MEDFORD OR
97504-4004
US

IV. Provider business mailing address

3524 HEATHROW WAY
MEDFORD OR
97504-4004
US

V. Phone/Fax

Practice location:
  • Phone: 541-646-3505
  • Fax: 541-646-3553
Mailing address:
  • Phone: 541-646-3505
  • Fax: 541-646-3553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD24327
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24327
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: