Individual
DR. GEORGE P. COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
347TH MEDICAL GROUP, 3278 MITCHELL BLVD, MOODY A F B, GA 31699-0001
(229) 257-3755
(229) 257-4672
Mailing address
3278 MICTCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-3891
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
55933
GA
Other
Enumeration date
11/15/2005
Last updated
07/08/2007
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