Provider Demographics
NPI:1790717171
Name:CASTEEL, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 MAIN ST E
Mailing Address - Street 2:STE C
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6460
Mailing Address - Country:US
Mailing Address - Phone:770-979-1818
Mailing Address - Fax:770-736-7134
Practice Address - Street 1:1976 MAIN ST E
Practice Address - Street 2:STE C
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6460
Practice Address - Country:US
Practice Address - Phone:770-982-0283
Practice Address - Fax:770-609-8443
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA043346207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000755741BMedicaid
GAE89359Medicare UPIN
GA000755741BMedicaid