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Individual

DR. JOHN JOSEPH KOVACICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2063
(276) 773-2118
Mailing address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2063
(276) 773-2118

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101038164
VA
207R00000X
Internal Medicine Physician
23588
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-07535
UNITED HEALTHCARE
NC
01
074399
BLUE CROSS AND BLUE SHIEL
VA
01
0918873
UNITED MINE WORKERS
NC
01
110133872
RAILROAD MEDICARE
NC
01
161810
BLACK LUNG
NC
01
224035
ANTHEM
VA
01
34DO247236
CLIA
NC
01
50294
BLUE CROSS BLUE SHIELD
NC
01
5891172
AETNA
NC
05
6084656
VA
01
833463
FIRST HEALTH
NC
05
8950294
NC
01
PARTNERS
PARTNERS
NC
Enumeration date
07/19/2006
Last updated
02/26/2013
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