Healthcare Provider Details

I. General information

NPI: 1932178100
Provider Name (Legal Business Name): MARVIN CARL COVEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 KANIS ROAD SUITE 400
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

PO BOX 56529
LITTLE ROCK AR
72205
US

V. Phone/Fax

Practice location:
  • Phone: 501-978-8618
  • Fax: 501-225-4921
Mailing address:
  • Phone: 501-978-8618
  • Fax: 501-225-4921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberC5648
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: