Provider Demographics
NPI:1962279331
Name:COVINGTON, CALLIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PROMENADE ST UNIT 1025
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7051
Mailing Address - Country:US
Mailing Address - Phone:843-422-2986
Mailing Address - Fax:
Practice Address - Street 1:15 HOSPITAL CTR STE 1
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2760
Practice Address - Country:US
Practice Address - Phone:843-689-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant