Provider Demographics
NPI:1215360557
Name:CASTLEVIEW PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:CASTLEVIEW PHYSICIAN PRACTICES LLC
Other - Org Name:DESERT ROCK INTERNAL MEDICINE & PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:945 W HOSPITAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4214
Mailing Address - Country:US
Mailing Address - Phone:435-637-7801
Mailing Address - Fax:435-637-7800
Practice Address - Street 1:945 W HOSPITAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4214
Practice Address - Country:US
Practice Address - Phone:435-637-7801
Practice Address - Fax:435-637-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty