Individual provider · Type 1 NPI
Mack Jay Groves Iv, DPM
Primary Podiatric Medicine Podiatrist · Covington, LA
NPI number
1265460877
Active
Practice location
323 S Tyler St
Covington, LA 70433-3037
Fax (985) 867-9001
Mailing address
323 S Street
Covington, LA 70433-2352
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | PD190R (LA) |
| Foot Surgery Podiatrist | 213ES0131X | PD190R (LA) |
| Primary Podiatric Medicine Podiatrist Primary | 213EP1101X | DPM.190R (LA) |
Primary Podiatric Medicine Podiatrist: Definition to come...
Another provider at this address
About NPI 1265460877
Mack Jay Groves Iv, DPM's National Provider Identifier is 1265460877, issued on Jun 30, 2006. The primary taxonomy on file is Primary Podiatric Medicine Podiatrist (213EP1101X), and the practice location is in Covington, LA. The record was last updated on Jun 30, 2025.