Provider Demographics
NPI:1922090836
Name:COVERT, GEORGE K (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:K
Last Name:COVERT
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 1:122 SOUTHERN DR
Mailing Address - Street 2:PO BOX 481
Mailing Address - City:ASHDOWN
Mailing Address - State:AR
Mailing Address - Zip Code:71822-3360
Mailing Address - Country:US
Mailing Address - Phone:870-898-6940
Mailing Address - Fax:870-898-4191
Practice Address - Street 1:122 SOUTHERN DR
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822-8668
Practice Address - Country:US
Practice Address - Phone:870-898-6940
Practice Address - Fax:870-898-4191
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203282301Medicaid
AR770262101OtherBREAST CARE
AR128201001Medicaid
AR608703900OtherDEPARTMENT OF LABOR
AR5J865OtherBLUE CROSS
AR1639100001OtherQUAL CHOICE
AR5J865G150Medicare UPIN
ARP00056552Medicare ID - Type UnspecifiedRAILROAD MEDICARE