Organization
IVEY FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI IVEY MD (PROPRIETOR/PHYSICIAN)
(479) 657-6501
Entity
Organization
Contact information
Practice address
2905 S WALTON BLVD., SUITE 17, BENTONVILLE, AR 72712-7848
(479) 657-6501
(479) 657-6375
Mailing address
PO BOX 3570, BENTONVILLE, AR 72712-7718
(479) 657-6501
(479) 657-6375
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R-4023
AR
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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