Costello, Timothy D

Costello, Timothy D is an individual health care provider with primary practice located at 620 North Main , Harrison AR 72601-2926. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Costello, Timothy D can be contacted via phone (870) 365-2000.

Contact Information

Primary practice address
620 North Main Harrison AR 72601-2926
Phone: (870) 365-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME137708 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2011003498 Missouri
Allopathic & Osteopathic Physicians / General Practice 208D00000X 0101236812 Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X E-7237 Arkansas

Profile Details

NPI number 1235195785
LBN Legal business name Costello, Timothy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Feb 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235195785 NPPES
Arkansas MEDICAID 190603001
Arkansas Other 51228

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