Organization
ROCKCASTLE VENTURES INC. D.B.A. CALLIE SHAFFER, M.D.
Active
Other names
Callie Shaffer, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY L. BULLOCK (DIRECTOR)
(606) 256-7761
Entity
Organization
Contact information
Practice address
140 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-4148
Mailing address
PO BOX 1525, MOUNT VERNON, KY 40456-1525
(606) 256-4148
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65942690
—
KY
Enumeration date
04/09/2007
Last updated
08/22/2020
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