Provider Demographics
NPI:1932543899
Name:COSTELLO, BRITTANY M (MD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:M
Last Name:COSTELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SAINT FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-1819
Mailing Address - Country:US
Mailing Address - Phone:052-219-1450
Mailing Address - Fax:
Practice Address - Street 1:51 TACON ST STE D
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3123
Practice Address - Country:US
Practice Address - Phone:251-341-2879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34135207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology