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Mr. Clint M. Costanza, ,PA
Surgical Physician Assistant in Baton Rouge, Louisiana
NPI 1619266954

Clint M. Costanza is a Surgical Physician Assistant based in Baton Rouge, LA and is specialized in Surgical. Clint M. Costanza practices in Baton Rouge, LA and has the professional credentials of ,PA. The NPI Number for Clint M. Costanza is 1619266954 and holds a License No. PA.200436 (Louisiana).

The current practice location address for Clint M. Costanza is 9001 Summa Ave, Baton Rouge, LA and can be reached out via phone at 225-761-5200 and via fax at 225-761-5702.

Location: 9001 Summa Ave, Baton Rouge, LA, 70809-3726
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Provider Profile Details
NPI Number
1619266954
Provider Name
Clint M. Costanza
Credential
,PA
Provider Entity Type
Individual
Gender
Male
Address
9001 Summa Ave, Baton Rouge, LA, 70809-3726
Phone Number
225-761-5200
Fax Number
225-761-5702
Provider Enumeration Date
04/06/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
07908012 05 MS
2141252 05 LA
institution
Provider Business Practice Location Address Details
Address
9001 Summa Ave
City
State
Zip
70809-3726
Phone Number
225-761-5200
Fax Number
225-761-5702
person
Provider Business Mailing Address Details
Address
9001 Summa Ave
City
State
Zip
70809-3726
Phone Number
225-761-5200
Fax Number
225-761-5702
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA.200436 (Louisiana)
Definition
Definition to come...
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