Provider Demographics
NPI:1013196138
Name:HOWARD L COVERT
Entity Type:Organization
Organization Name:HOWARD L COVERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:KNAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-544-3325
Mailing Address - Street 1:125 S MANCHESTER ST # 248
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1220
Mailing Address - Country:US
Mailing Address - Phone:937-544-3325
Mailing Address - Fax:937-544-8937
Practice Address - Street 1:125 S MANCHESTER ST # 248
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1220
Practice Address - Country:US
Practice Address - Phone:937-544-3325
Practice Address - Fax:937-544-8937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9269801Medicare PIN