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Individual

DR. RYDER LANE COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
611 ALCORN DR, CORINTH, MS 38834-9388
(662) 293-1143
Mailing address
611 ALCORN DR, CORINTH, MS 38834-9388

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
COST-GQ4B33
MS

Other

Enumeration date
06/06/2023
Last updated
06/07/2023
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