Organization
COVERT CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE K COVERT MD (SOLE OWNER)
(870) 898-6940
Entity
Organization
Contact information
Practice address
122 SOUTHERN DR, ASHDOWN, AR 71822-8668
(870) 898-6940
(870) 898-4191
Mailing address
PO BOX 481, ASHDOWN, AR 71822-0481
(870) 898-6940
(870) 898-4191
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E-0730
AR
261QR1300X
Rural Health Clinic/Center
E-0730
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639100001
QUALCHOICE
—
05
—
176100002
—
AR
05
—
203282301
—
TX
01
—
5J865
BLUE CROSS
—
01
—
608703900
DEPART OF LABOR
—
01
—
770262101
MEDICAID BREASTCARE
—
01
—
P00056552
RR MEDICARE
—
Enumeration date
01/09/2009
Last updated
08/27/2010
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