Joseph Patrick Costello III MD

NPI 1073607651 - Specialist - 174400000X

NPI Details
NPI 1073607651
Gender Male
Enumeration Date 10/03/2006
Last Updated 11/30/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
4212 N ILLINOIS ST
SWANSEA IL, 62226-1835, US
Phone (618) 233-6685
Fax (618) 233-6616
Business Location
PO BOX 217
O FALLON IL, 62269-0217, US
Phone (618) 233-6685
Fax (618) 233-6616
Toxanomy
Taxonomy Code 174400000X
License State Illinois
License Number 036079559
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According to our database, Dr. Joseph Patrick Costello III MD NPI is 1073607651, taxonomy code is 174400000X and license number is 036079559, license state is located at Illinois. Joseph Patrick Costello III MD physically located at 4212 N Illinois St, Swansea IL, 62226-1835. NPI Number Joseph Patrick Costello III MD has the Individual type.

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1073607651 NPI number is provided on an as is basis without warranty of any kind. 1073607651 is maintained by the National Plan & Provider Enumeration System. The contents of Joseph Patrick Costello III MD are for informational purposes only.