Provider Demographics
NPI:1144564717
Name:COVENANT GERIATRICS PLLC
Entity Type:Organization
Organization Name:COVENANT GERIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CULVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-899-9080
Mailing Address - Street 1:5751 UPTAIN RD
Mailing Address - Street 2:STE 100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-4077
Mailing Address - Country:US
Mailing Address - Phone:423-899-9080
Mailing Address - Fax:423-424-3690
Practice Address - Street 1:3016 CANE CREEK RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-8743
Practice Address - Country:US
Practice Address - Phone:828-628-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty