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1700832011
CHAD DONALD COSTLEY
DECATUR, GA
NPI
1700832011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA 054263)
Enumeration Date
2006-05-26
Last Update Date
2024-01-18
Business Address
Dr. CHAD DONALD COSTLEY M.D.
315 W PONCE DE LEON AVE STE 110
DECATUR, GA 30030-2441
Phone number: 404-371-9673
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Mailing Address
Dr. CHAD DONALD COSTLEY M.D.
315 W PONCE DE LEON AVE STE 110
DECATUR, GA 30030-2441
Phone number: 404-537-2521
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