MEDICARE: DR. JOHN CASTLE D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	DP00246	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205839057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CASTLE D.P.M.

Provider Business Mailing Address
First Line	:	1227 NE 7TH ST
Second Line	:	STE A
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1430
Country	:	US
Telephone Number	:	541-471-3668
Fax Number	:	541-471-4814

Provider Business Practice Location Address
First Line	:	1227 NE 7TH ST
Second Line	:	STE A
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1430
Country	:	US
Telephone Number	:	541-471-3668
Fax Number	:	541-471-4814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/27/2023

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Directions to “ DR. JOHN CASTLE D.P.M.” Practice Location

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