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General NPI Number Information
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NPI Number | 1346858255
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Entity Type | Organization
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Legal Business Name | CASTELLUM MEDICAL CONSULTANTS LLC
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1725 ELECTRIC AVE STE 100D
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2608
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Country | US
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Telephone | 706-518-6986
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Fax | 855-576-4188
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Provider Business Mailing Address
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Address Line | 1725 ELECTRIC AVE STE 100D
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2608
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Country | US
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Telephone | 706-262-7319
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Fax | 855-576-4188
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT N PRICE III
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Credential | MD
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Telephone | 706-247-1860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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