Healthcare Provider Details

I. General information

NPI: 1003026790
Provider Name (Legal Business Name): GEORGE K COVERT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 WEST MAIN
ASHDOWN AR
71822-3360
US

IV. Provider business mailing address

PO BOX 181
ASHDOWN AR
71822-0181
US

V. Phone/Fax

Practice location:
  • Phone: 870-898-6940
  • Fax: 870-898-4191
Mailing address:
  • Phone: 870-898-6940
  • Fax: 870-898-4191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE0730
License Number StateAR

VIII. Authorized Official

Name: GEORGE K COVERT
Title or Position: MD
Credential: MD
Phone: 870-898-6940