Individual
WALTER WOOLFOLK COSTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2820 E ROCK HAVEN ROAD, SUITE 210, HARRISONVILLE, MO 64701
(816) 380-2446
(816) 380-4791
Mailing address
2820 E ROCK HAVEN ROAD, SUITE 210, HARRISONVILLE, MO 64701
(816) 380-2446
(816) 380-4791
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2010007567
MO
Other
Enumeration date
06/22/2006
Last updated
03/17/2011
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