Individual
BRANDON W COVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-6611
(417) 347-6662
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-6611
(417) 347-6662
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2019024227
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106093
BCBS KS FOR KS LOCATION
—
05
—
200346940D
—
KS
05
—
207364902
—
MO
01
—
35466021
BCBS OF KC
MO
01
—
843471
BCBS KS FOR MO LOCATION
—
01
—
P00364462
RR MEDICARE GROUP CK7871
—
Enumeration date
04/21/2006
Last updated
08/16/2019
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