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General NPI Number Information
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NPI Number | 1306814389
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Entity Type | Organization
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Legal Business Name | THE COVENANT GROUP PA
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 8929 PARALLEL PKWY
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City | KANSAS CITY
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State | KS
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Zip | 66112-1689
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Country | US
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Telephone | 913-596-4180
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Fax | 913-596-4797
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Provider Business Mailing Address
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Address Line | 10975 BENSON ST STE 250
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1534
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Country | US
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Telephone | 913-469-4244
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Fax | 913-469-1939
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARK S HOLCOMB
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Credential | MD
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Telephone | 913-469-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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