Individual provider · Type 1 NPI
Joseph Patrick Costello Iii, MD
Specialist · Swansea, IL
NPI number
1073607651
Active
Practice location
4212 N Illinois St
Swansea, IL 62226-1835
Fax (618) 233-6616
Mailing address
PO Box 217
O Fallon, IL 62269-0217
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 036079559 (IL) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Another provider at this address
About NPI 1073607651
Joseph Patrick Costello Iii, MD's National Provider Identifier is 1073607651, issued on Oct 3, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Swansea, IL. The record was last updated on Nov 30, 2011.