Provider Demographics
NPI:1205880689
Name:CASTLE, JAMES JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOHN
Last Name:CASTLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W COUNTRY CLUB RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5240
Mailing Address - Country:US
Mailing Address - Phone:575-625-2669
Mailing Address - Fax:575-624-4599
Practice Address - Street 1:300 W COUNTRY CLUB RD
Practice Address - Street 2:SUITE 130
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5202
Practice Address - Country:US
Practice Address - Phone:575-625-2669
Practice Address - Fax:575-624-4599
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-930-91208600000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM61780049Medicaid
NPI AND TINOtherBLUE CROSS/BLUE SHIELD
NM61780049Medicaid
348629603Medicare PIN