Costello, Patrick Nicholas

Costello, Patrick Nicholas is an individual health care provider with primary practice located at 400 N State Of Franklin Rd , Johnson City TN 37604-6035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Costello, Patrick Nicholas can be contacted via phone (423) 431-6389.

Contact Information

Primary practice address
400 N State Of Franklin Rd Johnson City TN 37604-6035
Phone: (423) 431-6389
Fax: (423) 431-6331
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD31483 Tennessee

Profile Details

NPI number 1710952320
LBN Legal business name Costello, Patrick Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2006
Last updated Feb 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710952320 NPPES
Tennessee Other 3141925 BCBS
Tennessee MEDICAID 3849073 BCBS
Tennessee MEDICAID 64011265 BCBS
Tennessee MEDICAID 6600018 BCBS

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