Provider Demographics
NPI:1346577632
Name:RICHARD COVEY, MD, PC
Entity type:Organization
Organization Name:RICHARD COVEY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-777-8000
Mailing Address - Street 1:3155 STILLWATER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7172
Mailing Address - Country:US
Mailing Address - Phone:928-777-8000
Mailing Address - Fax:928-777-8104
Practice Address - Street 1:3155 STILLWATER DR
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7172
Practice Address - Country:US
Practice Address - Phone:928-777-8000
Practice Address - Fax:928-777-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28184261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care