# MARK IVEY JR MD PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497813141
- **Authorized official:** MARK IVEY JR. MD (OWNER)
- **Authorized official phone:** (928) 474-8901

## Contact information

- **Practice address:** 1106 N BEELINE HWY, PAYSON, AZ 85541-3714
- **Practice address phone:** (928) 474-8901
- **Practice address fax:** (928) 474-8947
- **Mailing address:** PO BOX 129, PAYSON, AZ 85547-0129
- **Mailing address phone:** (928) 474-8901
- **Mailing address fax:** (928) 474-8947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10659 | AZ | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 245341 | — | AZ |