Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MACK JAY GROVES IV, DPM
Active Sole ProprietorDR. MACK JAY GROVES IV, DPM is a Radiology Podiatrist healthcare provider located in COVINGTON, Louisiana. NPI 1265460877 is currently active in the NPPES registry. Verify at CMS.
Radiology Podiatrist · COVINGTON, LA
Registration Details
- NPI Number
- 1265460877
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 30, 2006 (20.09971150699 yrs)
- Last Updated
- Jun 30, 2025
- Licenses
-
PD190R (LA)PD190R (LA)DPM.190R (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
323 S TYLER STCOVINGTON, LA, 704333037Browse LA providers · Browse ZIP 70433
- Phone
- 9858679605
- Fax
- 9858679001
- Primary Specialty
-
Radiology Podiatrist
213EP1101X
- Additional Specialty
- Foot Surgery Podiatrist
- Additional Specialty
- Radiology Podiatrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.