Individual
DR. DARY JONATHAN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 E CHESTNUT ST # LEVEL6, LOUISVILLE, KY 40202-1713
(502) 588-9587
(502) 588-9580
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
TP891
KY
Other
Enumeration date
06/01/2007
Last updated
11/29/2023
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