Organization
MARK IVEY JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK IVEY JR. MD (OWNER)
(928) 474-8901
Entity
Organization
Contact information
Practice address
1106 N BEELINE HWY, PAYSON, AZ 85541-3714
(928) 474-8901
(928) 474-8947
Mailing address
PO BOX 129, PAYSON, AZ 85547-0129
(928) 474-8901
(928) 474-8947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10659
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245341
—
AZ
Enumeration date
12/05/2006
Last updated
08/22/2020
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