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Contact Information

MB COSTELLO ENTERPRISES LLC
1501 LAKELAND DR STE 251
JACKSON, MS39216-4848
 Phone: 601-321-8000
 Fax: 601-321-8001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for MB COSTELLO ENTERPRISES LLC · (Female)

NPI # 1982996567
Status Active
Credentials
Entity Individual
Enumeration date 05/13/2011
Last updated 09/29/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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