Castleberry, Gordon Michael

Castleberry, Gordon Michael is an individual health care provider with primary practice located at 1207 Highway 182 W Ste B , Starkville MS 39759-9820. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Castleberry, Gordon Michael can be contacted via phone (662) 324-1097.

Contact Information

Primary practice address
1207 Highway 182 W Ste B Starkville MS 39759-9820
Phone: (662) 324-1097
Fax: (662) 324-2412
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 17324 Mississippi
Allopathic & Osteopathic Physicians / Urology 208800000X 17324 Mississippi

Profile Details

NPI number 1407854417
LBN Legal business name Castleberry, Gordon Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Aug 12th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407854417 NPPES
Mississippi MEDICAID 07481088

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