Provider Demographics
NPI:1831124874
Name:KOSTYLO, FRANK F (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:F
Last Name:KOSTYLO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1754
Mailing Address - Country:US
Mailing Address - Phone:843-689-3338
Mailing Address - Fax:843-681-3102
Practice Address - Street 1:92 MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1754
Practice Address - Country:US
Practice Address - Phone:843-689-3338
Practice Address - Fax:843-681-3102
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC71213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP9969Medicaid
SCPD0715Medicaid
SCAA8157A643Medicare UPIN