Provider Demographics
NPI:1972540060
Name:CASTILLO, ARMANDO R JR (MD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:R
Last Name:CASTILLO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-533-4786
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501
Practice Address - Country:US
Practice Address - Phone:770-533-6645
Practice Address - Fax:770-535-7445
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA54989207P00000X
TXR63582080N0001X
GA0549892080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385001801Medicaid
GA4519014OtherAETNA
GA374271OtherCIGNA
GA1972540060OtherUNITED HEALTHCARE
GA01208122OtherAMERIGROUP
GA247262164FMedicaid
GA459338OtherWELLCARE
GA52703314OtherBCBS
GA374271OtherCIGNA