Healthcare Provider Details

I. General information

NPI: 1922090836
Provider Name (Legal Business Name): GEORGE K COVERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 SOUTHERN DR
ASHDOWN AR
71822-8668
US

IV. Provider business mailing address

122 SOUTHERN DR PO BOX 481
ASHDOWN AR
71822-3360
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:
Title or Position:
Credential:
Phone: