# EASTERN KENTUCKY FAMILY MEDICINE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730337247
- **Authorized official:** JASON CASTLE M.D. (SOLE MEMBER)
- **Authorized official phone:** (606) 789-4255

## Contact information

- **Practice address:** 713 BROADWAY ST, PAINTSVILLE, KY 41240-1465
- **Practice address phone:** (606) 789-4255
- **Practice address fax:** (606) 886-9908
- **Mailing address:** P.O. BOX 1810, PRESTONSBURG, KENTUCKY 41653
- **Mailing address phone:** (606) 886-0224
- **Mailing address fax:** (606) 886-9908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 42069 | KY | Yes |

## Other

- **Enumeration date:** 09/09/2008
- **Last updated:** 05/04/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100056750 | — | KY |