Provider Demographics
NPI:1740201599
Name:COVINGTON, MARK OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:OWEN
Last Name:COVINGTON
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 1:4860 COLLEGE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1681
Mailing Address - Country:US
Mailing Address - Phone:816-478-4200
Mailing Address - Fax:816-875-2597
Practice Address - Street 1:4880 NE GOODVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1996
Practice Address - Country:US
Practice Address - Phone:816-478-4200
Practice Address - Fax:816-478-2597
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009003008207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology