Individual
KYLE NICHOLAS CASTLEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 427-6811
Mailing address
1350 ZEPHYR CT, CUMMING, GA 30041-8094
(770) 342-9609
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12292
GA
Other
Enumeration date
05/06/2024
Last updated
05/13/2024
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