Provider Demographics
NPI:1932217742
Name:CASTLE, STEPHEN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:CASTLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7251 W 20TH ST
Mailing Address - Street 2:BLDG E
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4625
Mailing Address - Country:US
Mailing Address - Phone:970-330-6075
Mailing Address - Fax:970-330-8962
Practice Address - Street 1:7251 W 20TH ST
Practice Address - Street 2:BLDG E
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4625
Practice Address - Country:US
Practice Address - Phone:970-330-6075
Practice Address - Fax:970-330-8962
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO34577- COLORADO207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G24454Medicare UPIN
C8992Medicare ID - Type Unspecified