Healthcare Provider Details

I. General information

NPI: 1215360557
Provider Name (Legal Business Name): CASTLEVIEW PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W HOSPITAL DR SUITE 4
PRICE UT
84501-4214
US

IV. Provider business mailing address

945 W HOSPITAL DR SUITE 4
PRICE UT
84501-4214
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-7801
  • Fax: 435-637-7800
Mailing address:
  • Phone: 435-637-7801
  • Fax: 435-637-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000