Provider Demographics
NPI:1932178100
Name:COVEY, MARVIN CARL (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:CARL
Last Name:COVEY
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:PO BOX 56529
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-978-8618
Mailing Address - Fax:501-225-4921
Practice Address - Street 1:9101 KANIS ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-978-8618
Practice Address - Fax:501-225-4921
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5648207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
51184Medicare ID - Type Unspecified
D84124Medicare UPIN