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THOMAS A CASTILLO DO

>> Ophthalmology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1700805454

Individual Registrant:
 THOMAS A CASTILLO DO
Gender: M
Not Sole Proprietor

Location and contact information for practice:
240 CORPORATE DRIVE  BEAVER DAM, WI 53916-3115 US
Tel: 920-887-1151  Fax: 920-887-3353

Contact information for business:
240 CORPORATE DRIVE  BEAVER DAM, WI 53916-3115 US
Tel: 920-887-1151  Fax: 920-887-3353

Registration Information:
NPI: 1700805454
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207W00000XAllopathic & Osteopathic Physicians
Ophthalmology
WI40496

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
TAX ID39115615601
JOHN DEERE HEALTH PLANWI011301
RAIL ROAD MEDICARE180034885WI01
NETWORK HEALTH PLAN3166201
DEAN CARE HMO1199501
30088300WI05
UNITY HMO3911561561301
PHYSICIANS PLUS HMO102450101




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