MEDICARE: JAIME D CASTILLO JR. M.D.

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	207R00000X	Internal Medicine Physician	18283	MS

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	:	1538179536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME D CASTILLO JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 432
Second Line	:
City	:	HOUSTON
State	:	MS
Zip	:	38851-0432
Country	:	US
Telephone Number	:	662-456-3700
Fax Number	:	662-456-1717

Provider Business Practice Location Address
First Line	:	1002 E MADISON ST
Second Line	:
City	:	HOUSTON
State	:	MS
Zip	:	38851-2428
Country	:	US
Telephone Number	:	662-456-3000
Fax Number	:	662-456-9439

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/18/2024

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