Basic Information
Provider Information
NPI: 1164451209
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASTANEDA
FirstName: FRANCISCO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1401 APPLEWOOD DR
Address2: SUITE 1
City: DALTON
State: GA
PostalCode: 307202699
CountryCode: US
TelephoneNumber: 7062705033
FaxNumber: 7063707749
Practice Location
Address1: 1401 APPLEWOOD DR
Address2: SUITE 1
City: DALTON
State: GA
PostalCode: 30720
CountryCode: US
TelephoneNumber: 7062705033
FaxNumber: 7063707749
Other Information
ProviderEnumerationDate: 07/01/2006
LastUpdateDate: 06/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X33549GAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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