J L Costin, Md, PC
NPI #1669522199 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1669522199
- Entity Type
- Organization
- Organization Name
- J L Costin, Md, PC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Jan 10, 2007
- Last Updated
- Nov 28, 2007
Practice Location
- Address
- 3069 N WESTWOOD BLVD
- Address 2
- STE A
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901
- Phone
- (573) 785-8405
Authorized Official
- Name
- MRS. SUE E COSTIN
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (573) 785-8405
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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