Provider Demographics
NPI:1508891375
Name:KOVACS, DONALD J (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:KOVACS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1358 LUTZTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17007-9302
Mailing Address - Country:US
Mailing Address - Phone:717-258-3274
Mailing Address - Fax:717-258-0311
Practice Address - Street 1:1358 LUTZTOWN RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17007-9302
Practice Address - Country:US
Practice Address - Phone:717-258-3274
Practice Address - Fax:717-258-0311
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019734E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0571289Medicaid
PA01475201OtherCAPITAL BLUE CROSS
PA4341543OtherAETNA
PAKO060936OtherHIGHMARK BLUE SHIELD
PA390222OtherCIGNA
PA0571289Medicaid