Provider Demographics
NPI:1366973505
Name:COVINGTON, JEFFREY DANIEL (MD, PHD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DANIEL
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:MD, PHD
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 3780
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38803-3780
Mailing Address - Country:US
Mailing Address - Phone:318-841-9550
Mailing Address - Fax:188-419-5473
Practice Address - Street 1:3290 KNIGHT ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2720
Practice Address - Country:US
Practice Address - Phone:318-621-8820
Practice Address - Fax:318-841-9547
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA338432207ZP0102X
KS04-50522207ZP0102X
MS32892207ZP0102X
VT042.0015199207ZP0102X
TXU8874207ZP0102X
COCDR.0004827207ZP0102X
NMMD2025-0242207ZP0102X
ARE-17702207ZP0102X
AL48089207ZP0102X
OK42985207ZP0102X
TN70547207ZP0102X
WI13079-320207ZP0102X
390200000X
SC87422207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program