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Individual

MARK ANDREW KOSTELNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD, BCPS

Contact information

Practice address
375 E MILLSAP RD STE 3, FAYETTEVILLE, AR 72703-6289
(918) 809-7822
(479) 445-6032
Mailing address
375 E MILLSAP RD STE 3, FAYETTEVILLE, AR 72703-6289
(918) 809-7822
(479) 445-6032

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
14707
OK
1835C0207X
Compounded Sterile Preparations Pharmacist
Primary
PD14410
AR

Other

Enumeration date
07/22/2010
Last updated
04/11/2023
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