ANTONIO REYES DEL CASTILLO JR. (NPI# 1790265932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790265932 |
| Entity Type | Individual |
| Full Name | ANTONIO REYES DEL CASTILLO JR. |
| Practice Address |
590 Parchman Road 12 Parchman MS 38738-3001 |
| Mailing Address |
1308 S Fifth Ave Cleveland MS 38732-3609 |
| Practice Telephone | 6627456611 |
| Mailing Telephone | 6625456414 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 966-L | MS | Allopathic & Osteopathic Physicians |
| Street Address |
590 PARCHMAN ROAD 12 |
| City | PARCHMAN |
| State | MS |
| Zip Code | 38738-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548633431 | Nina Waltzer | Nurse Practitioner | Po Box Drawer E, Parchman, MS 38738 | 2015-11-02 |
| 1215251848 | Thomas Michael Lehman | Internal Medicine | Highway 49 W, Mississippi State Penitentiary Medical Unit, Parchman, MS 38738 | 2010-03-25 |
| 1497999437 | Juan Mercado Santos | General Practice | Hwy49w Ms. Dept of Correction, Podrawer E, Parchman, MS 38738 | 2009-04-21 |
| 1265616262 | James Benjamin Burke | General Practice | Hwy 49 West Unit 42, Parchman, MS 38738 | 2007-12-27 |
| 1326282757 | Myung Woon Kim | General Practice | Hwy 49 W, Msp U42, Parchman, MS 38738-0000 | 2009-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548633431 | Nina Waltzer | Nurse Practitioner | Po Box Drawer E, Parchman, MS 38738 | 2015-11-02 |
| 1215251848 | Thomas Michael Lehman | Internal Medicine | Highway 49 W, Mississippi State Penitentiary Medical Unit, Parchman, MS 38738 | 2010-03-25 |
| 1326282757 | Myung Woon Kim | General Practice | Hwy 49 W, Msp U42, Parchman, MS 38738-0000 | 2009-04-29 |
| 1497999437 | Juan Mercado Santos | General Practice | Hwy49w Ms. Dept of Correction, Podrawer E, Parchman, MS 38738 | 2009-04-21 |
| 1265616262 | James Benjamin Burke | General Practice | Hwy 49 West Unit 42, Parchman, MS 38738 | 2007-12-27 |
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326282757 | Myung Woon Kim | General Practice | Hwy 49 W, Msp U42, Parchman, MS 38738-0000 | 2009-04-29 |
| 1497999437 | Juan Mercado Santos | General Practice | Hwy49w Ms. Dept of Correction, Podrawer E, Parchman, MS 38738 | 2009-04-21 |
| 1265616262 | James Benjamin Burke | General Practice | Hwy 49 West Unit 42, Parchman, MS 38738 | 2007-12-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.