Dr Lawrence William Costa Jr, MD is a
Internal Medicine physician based in Monteagle, Tennessee. Dr Lawrence William Costa Jr is licensed to practice in Tennessee (license number MD0000018125) and his current practice location is 21 1st St., Monteagle, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(931) 924-4200.
NPI number for Dr Lawrence William Costa Jr is 1578616058 and his current mailing address is Po Box 9, Monteagle, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1578616058.
Physician's Profile
| Full Name | Dr Lawrence William Costa Jr |
|---|
| Gender | Male |
|---|
| Speciality | Internal Medicine |
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| Location | 21 1st St., Monteagle, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1578616058
- Provider Enumeration Date: 01/19/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Lawrence William Costa Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578616058 | NPI | - | NPPES |
| 917201 | Other | TN | HERITAGE JOHN DEERE |
| 3722428 | Medicaid | TN | |
| 688779 | Other | TN | BLUE CROSS PREFERRED |
| 4536007 | Other | TN | FEDERAL BLACK LUNG |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | MD0000018125 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lawrence William Costa Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Lawrence William Costa Jr, MD
Po Box 9,
Monteagle, TN 37356-0009
Ph: (931) 924-4200 | Dr Lawrence William Costa Jr, MD
21 1st St.,
Monteagle, TN 37356-0009
Ph: (931) 924-4200 |
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