Healthcare Provider Details

I. General information

NPI: 1992167308
Provider Name (Legal Business Name): MATTHEW HARRISON COVEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610
US

IV. Provider business mailing address

900 S LIMESTONE CTW 304
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-594-5554
  • Fax: 352-265-0379
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME141756
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: