Provider Demographics
NPI:1881008811
Name:CASTLEVIEW PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:CASTLEVIEW PHYSICIAN PRACTICES LLC
Other - Org Name:CASTLEVIEW FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDY
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 7
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4214
Mailing Address - Country:US
Mailing Address - Phone:435-637-6348
Mailing Address - Fax:435-637-6422
Practice Address - Street 1:945 W HOSPITAL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4214
Practice Address - Country:US
Practice Address - Phone:435-637-6348
Practice Address - Fax:435-637-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty