Provider Demographics
NPI:1477783736
Name:CASTILLO, AMY LENEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LENEE
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6275 EMERALD PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-3241
Mailing Address - Country:US
Mailing Address - Phone:614-792-5698
Mailing Address - Fax:773-869-3578
Practice Address - Street 1:750 E LONG ST STE 3000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1874
Practice Address - Country:US
Practice Address - Phone:614-340-6700
Practice Address - Fax:614-792-5699
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2023-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085003412363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0461301Medicaid