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Individual

MR. CORY M KOVAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
19350 E SILVER CREEK LN, QUEEN CREEK, AZ 85142-9064
(480) 718-5400
(877) 666-4624
Mailing address
729 S BURK ST, GILBERT, AZ 85296-2815
(480) 588-6213

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3363
AZ
363A00000X
Physician Assistant
Primary
3363
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023682
AZ
Enumeration date
06/03/2006
Last updated
02/02/2015
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