Provider Demographics
NPI:1699114595
Name:COVINGTON, JOSHUA DAREN (DO)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAREN
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 N 61ST ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-4168
Mailing Address - Country:US
Mailing Address - Phone:757-535-4516
Mailing Address - Fax:
Practice Address - Street 1:616 N 61ST ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-4168
Practice Address - Country:US
Practice Address - Phone:757-535-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71831-21207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology