MEDICARE: CASTLE CLINIC PLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	207Q00000X	Family Medicine Physician
3	207R00000X	Internal Medicine Physician
4	225100000X	Physical Therapist
5	363L00000X	Nurse Practitioner
6	208200000X	Plastic Surgery Physician

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	:	1447260765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASTLE CLINIC PLC

Provider Business Mailing Address
First Line	:	1416 S ROAN ST
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-7332
Country	:	US
Telephone Number	:	423-979-6257
Fax Number	:	423-979-6285

Provider Business Practice Location Address
First Line	:	1416 S ROAN ST
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-7332
Country	:	US
Telephone Number	:	423-979-6257
Fax Number	:	423-979-6285

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT C ALLEN
Credential	:	MD
Telephone Number	:	423-979-6257

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	09/11/2025

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Directions to “CASTLE CLINIC PLC ” Practice Location

Language	Start Address	Practice Location

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