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General NPI Number Information
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NPI Number | 1265594477
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Entity Type | Organization
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Legal Business Name | PHILIP W CASTER MD AND JOHN P CASTER MD LLC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 732 S MADISON AVE
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City | LEBANON
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State | MO
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Zip | 65536-3591
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Country | US
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Telephone | 417-532-9161
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Fax | 417-532-8360
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Provider Business Mailing Address
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Address Line | 732 S MADISON AVE
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City | LEBANON
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State | MO
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Zip | 65536-3591
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Country | US
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Telephone | 417-532-9161
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Fax | 417-532-8360
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILIP W CASTER
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Credential | MD
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Telephone | 417-532-9161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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