J L COSTIN, MD, PC


Address: 3069 N Westwood Blvd, Ste A, Poplar Bluff, MO 63901
Phone: 5737858405

J L COSTIN, MD, PC (NPI# 1669522199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669522199
Entity Type Organization
Organization Name J L COSTIN, MD, PC
Other Organization Name PHYSICIANS PATHOLOGY SERVICES
Practice Address 3069 N Westwood Blvd
Ste A
Poplar Bluff
MO 63901
Mailing Address Po Box 4057
Poplar Bluff
MO 63902-4057
Practice Telephone 5737858405
Practice Fax Number 5737780425
Mailing Telephone 5737858405
Mailing Fax Number 5737780425
Enumeration Date 2007-01-10
Last Update Date 2007-11-28
Authorized Official Name MRS. SUE E COSTIN (DIRECTOR OF OPERATIONS)
Authorized Official Telephone 5737858405
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory MO Laboratories

Other Provider Identifier

State Issuer Identifier Type Code
MO HEALTHLINK 114817 01
MO ARKANSAS FIRST SOURCE 98839 01
MO BLUE CROSS BLUE SHIELD 119564 01
MO BLUE CROSS BLUE SHIELD AL 74954 01
MO FIRST HEALTH 654990 01
AR ARK FIRST SOURCE 98839 01
MO RAILROAD MEDICARE P00199451 01

Other Provider/Organization Names

Other Name Type Code
Physicians Pathology Services Doing Business As Name - Organization

Office Location

Street Address 3069 N WESTWOOD BLVD
STE A
City POPLAR BLUFF
State MO
Zip Code 63901

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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.

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Competitor

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City POPLAR BLUFF
Zip Code 63901

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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