Provider Demographics
NPI:1639105638
Name:COVEY, JONATHAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:B
Last Name:COVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:620 SOUTHPOINTE CT.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3861
Mailing Address - Country:US
Mailing Address - Phone:719-375-1607
Mailing Address - Fax:719-434-1402
Practice Address - Street 1:620 SOUTHPOINTE CT.
Practice Address - Street 2:SUITE 215
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3861
Practice Address - Country:US
Practice Address - Phone:719-375-1607
Practice Address - Fax:719-434-1402
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO302582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F48551Medicare UPIN