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NPI Code Detail

MEDICARE: DON A KOVALSKY M.D.

MEDICARE: DON A KOVALSKY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine Physician036105282IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700853272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DON A KOVALSKY M.D.
Provider Business Mailing Address
First Line : 4121 VETERANS MEMORIAL DR
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6262
Country : US
Telephone Number : 618-242-3778
Fax Number : 618-242-2551
Provider Business Practice Location Address
First Line : 4121 VETERANS MEMORIAL DR
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6262
Country : US
Telephone Number : 618-242-3778
Fax Number : 618-242-2551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 12/23/2009

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Directions to “ DON A KOVALSKY M.D.” Practice Location

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