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General NPI Number Information
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NPI Number | 1073601514
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Entity Type | Individual
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Provider Name | KAREN Y CASTLEBERRY O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 3700 ATLANTA HWY #141
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City | ATHENS
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State | GA
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Zip | 30606-7201
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Country | US
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Telephone | 706-613-6409
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Fax | 706-613-5514
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Provider Business Mailing Address
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Address Line | 3700 ATLANTA HWY SUITE 141
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City | ATHENS
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State | GA
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Zip | 30606-7201
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Country | US
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Telephone | 706-613-6409
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Fax | 706-613-5514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 1324
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 3628
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License Number State | MI
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