Provider Demographics
NPI:1629068721
Name:COVINGTON INTERNAL PHYSICIANS PC
Entity Type:Organization
Organization Name:COVINGTON INTERNAL PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-837-3735
Mailing Address - Street 1:56 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38058-6054
Mailing Address - Country:US
Mailing Address - Phone:901-837-3735
Mailing Address - Fax:901-837-8532
Practice Address - Street 1:56 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNFORD
Practice Address - State:TN
Practice Address - Zip Code:38058-6054
Practice Address - Country:US
Practice Address - Phone:901-837-3735
Practice Address - Fax:901-837-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN018580204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN82503OtherBLUE CROSS
TNA99479Medicare UPIN
TN3708127Medicare ID - Type UnspecifiedGROUP ID NUMBER