Joseph M Costello, DPM | |
2121 N Baltimore St, Kirksville, MO 63501-5110 | |
(660) 342-0175 | |
Not Available |
Full Name | Joseph M Costello |
---|---|
Gender | Male |
Speciality | Podiatrist |
Location | 2121 N Baltimore St, Kirksville, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952613671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 2014003755 (Missouri) | Primary |
Provider Name | Preferred Podiatry Group Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1720037138 PECOS PAC ID: 3971412677 Enrollment ID: O20060814000285 |
Mailing Address | Practice Location Address |
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Joseph M Costello, DPM 1920 Salter Pl, Kirksville, MO 63501-5165 Ph: () - | Joseph M Costello, DPM 2121 N Baltimore St, Kirksville, MO 63501-5110 Ph: (660) 342-0175 |
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