Provider Demographics
NPI:1629427463
Name:CASTLE, WILLIAM MILLER
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MILLER
Last Name:CASTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 SAMS WAY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2554
Mailing Address - Country:US
Mailing Address - Phone:276-676-3459
Mailing Address - Fax:
Practice Address - Street 1:579 SAMS WAY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2554
Practice Address - Country:US
Practice Address - Phone:276-676-3459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705089724171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications