Healthcare Provider Details

I. General information

NPI: 1164341327
Provider Name (Legal Business Name): FRANCES CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 WACCAMAW MEDICAL PARK DR
CONWAY SC
29526-8903
US

IV. Provider business mailing address

3077 MOSS BRIDGE LN
MYRTLE BEACH SC
29579-3596
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-4888
  • Fax:
Mailing address:
  • Phone: 830-317-9282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57241
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: