Individual
JAMISON FORREST COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
240 S MAIN ST STE A, WOLFEBORO, NH 03894-4411
(603) 569-7500
Mailing address
240 S MAIN ST STE A, WOLFEBORO, NH 03894-4411
(603) 569-7574
(603) 569-7582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18414
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3109500
—
NH
Enumeration date
04/22/2014
Last updated
03/13/2025
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