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General NPI Number Information
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NPI Number | 1982841144
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Entity Type | Organization
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Legal Business Name | COVERT CLINIC, P.A.
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 08/27/2010
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Provider Practice Location Address
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Address Line | 122 SOUTHERN DR
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City | ASHDOWN
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State | AR
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Zip | 71822-8668
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Country | US
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Telephone | 870-898-6940
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Fax | 870-898-4191
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Provider Business Mailing Address
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Address Line | PO BOX 481
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City | ASHDOWN
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State | AR
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Zip | 71822-0481
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Country | US
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Telephone | 870-898-6940
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Fax | 870-898-4191
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Authorized Official
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Title or Position | SOLE OWNER
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Name | GEORGE K COVERT
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Credential | MD
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Telephone | 870-898-6940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | E-0730
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | E-0730
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License Number State | AR
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