MR. Edward T Costello, P.A.

NPI #1730104340 in Malvern, Arkansas

Provider Information

NPI Number: 1730104340
Entity Type: Individual
Name: MR. Edward T Costello, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Jul 13, 2006
Last Updated: May 17, 2021

Practice Location

Address: 1002 SCHNEIDER DR
Address 2: SUITE 104
City: Malvern
State: Arkansas
ZIP Code: 72104-4816
Phone: (501) 332-7981

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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