Provider Demographics
NPI:1184665580
Name:COVIN, FISHER ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FISHER
Middle Name:ALAN
Last Name:COVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5003 HARDY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1331
Mailing Address - Country:US
Mailing Address - Phone:601-261-5700
Mailing Address - Fax:601-261-5777
Practice Address - Street 1:5003 HARDY ST STE 200
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1331
Practice Address - Country:US
Practice Address - Phone:601-261-5700
Practice Address - Fax:601-261-5777
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS15293207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS15293OtherMEDICAL LICENSE