Organization
GUY J. KOVACEVICH, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY J KOVACEVICH MD (OWNER/PRESIDENT)
(970) 949-5434
Entity
Organization
Contact information
Practice address
142 BEAVER CREEK PLACE, AVON, CO 81620
(970) 949-5434
(970) 949-0376
Mailing address
PO BOX 2819, AVON, CO 81620-2819
(970) 949-5434
(970) 949-0376
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
30110
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30110
LICENSE
CO
Enumeration date
09/30/2010
Last updated
09/30/2010
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