Provider Demographics
NPI:1457497620
Name:COVERT, HOWARD L (OD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:L
Last Name:COVERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:MR
Other - First Name:HOWARD
Other - Middle Name:L
Other - Last Name:COVERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-0248
Mailing Address - Country:US
Mailing Address - Phone:937-544-3325
Mailing Address - Fax:937-544-8937
Practice Address - Street 1:125 S MANCHESTER ST
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT46958152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9269801Medicare UPIN
OH0691830001Medicare NSC