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General NPI Number Information
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NPI Number | 1346577632
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Entity Type | Organization
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Legal Business Name | RICHARD COVEY, MD, PC
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 3155 STILLWATER DR SUITE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-7172
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Country | US
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Telephone | 928-777-8000
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Fax | 928-777-8104
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Provider Business Mailing Address
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Address Line | 3155 STILLWATER DR SUITE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-7172
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Country | US
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Telephone | 928-777-8000
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Fax | 928-777-8104
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Authorized Official
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Title or Position | CEO
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Name | DR. RICHARD COVEY
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Credential | M.D.
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Telephone | 928-777-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 28184
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License Number State | AZ
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