Provider Demographics
NPI:1699772095
Name:KOVACS, ROBERT EARL (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EARL
Last Name:KOVACS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W WATER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47348-9501
Mailing Address - Country:US
Mailing Address - Phone:765-348-3904
Mailing Address - Fax:765-348-3904
Practice Address - Street 1:1300 W WATER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD CITY
Practice Address - State:IN
Practice Address - Zip Code:47348-9501
Practice Address - Country:US
Practice Address - Phone:765-348-3904
Practice Address - Fax:765-348-3904
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU30717Medicare UPIN
IN550820Medicare ID - Type Unspecified