Individual
DR. KAREN Y CASTLEBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3700 ATLANTA HWY, #141, ATHENS, GA 30606-7201
(706) 613-6409
(706) 613-5514
Mailing address
3700 ATLANTA HWY, SUITE 141, ATHENS, GA 30606-7201
(706) 613-6409
(706) 613-5514
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
1324
GA
152WC0802X
Corneal and Contact Management Optometrist
3628
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00972771A
—
GA
05
—
101679
—
GA
01
—
10633
COLE LOCATION #102007
GA
01
—
41ZCFDD
CARRIER PROVIDER #
GA
Enumeration date
10/10/2006
Last updated
01/26/2010
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