Individual
DR. RYAN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
225 E JACKSON AVE, JONESBORO, AR 72401-3119
(870) 972-4100
Mailing address
965 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9401
(901) 227-4692
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32754
MS
207R00000X
Internal Medicine Physician
4623
TN
207R00000X
Internal Medicine Physician
Primary
E-11969
AR
Other
Enumeration date
03/24/2016
Last updated
01/24/2024
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