Healthcare Provider Details

I. General information

NPI: 1144564717
Provider Name (Legal Business Name): COVENANT GERIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 CANE CREEK RD
FAIRVIEW NC
28730-8743
US

IV. Provider business mailing address

5751 UPTAIN RD STE 100
CHATTANOOGA TN
37411-4077
US

V. Phone/Fax

Practice location:
  • Phone: 828-628-2800
  • Fax:
Mailing address:
  • Phone: 423-899-9080
  • Fax: 423-424-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD L CULVER
Title or Position: OWNER
Credential: MD
Phone: 423-899-9080