=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265448922
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHY MICHELLE CASTLEMAN P.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1595 HARRISON ST
-----------------------------------------------------
City | BATESVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72501-7222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-793-4179
-----------------------------------------------------
Fax | 870-793-7303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 PIERCE LN
-----------------------------------------------------
City | BATESVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72501-8821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-251-2190
-----------------------------------------------------
Fax | 870-251-3309
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 7224
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------