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General NPI Number Information
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NPI Number | 1033462239
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Entity Type | Individual
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Provider Name | JASON RONALD KOVAC MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 11405 PENNSYLVANIA ST STE 104
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City | CARMEL
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State | IN
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Zip | 46032-6905
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Country | US
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Telephone | 317-912-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 9110 E NICHOLS AVE STE 150
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City | CENTENNIAL
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State | CO
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Zip | 80112-3450
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Country | US
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Telephone | 720-666-4739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036162908
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 59626
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 01073892A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 2025011426
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 83989-20
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35.147072
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301508621
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License Number State | MI
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