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General NPI Number Information
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NPI Number | 1588892293
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Entity Type | Organization
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Legal Business Name | COVINGTON CLINIC PC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 07/04/2009
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Provider Practice Location Address
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Address Line | 4480 COVINGTON HWY SUITE B
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City | DECATUR
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State | GA
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Zip | 30035-1218
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Country | US
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Telephone | 404-775-1973
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Fax |
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Provider Business Mailing Address
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Address Line | 4480 COVINGTON HWY SUITE B
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City | DECATUR
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State | GA
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Zip | 30035-1218
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Country | US
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Telephone | 404-775-1973
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. FRANK OJO DANIA
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Credential | M.D., M.S.
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Telephone | 770-688-5558
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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 | 061956
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License Number State | GA
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