| Ivey Family Medicine | |
|
2905 S Walton Blvd. Suite 17 Bentonville AR 72712-7848 | |
| (479) 657-6501 | |
| (479) 657-6375 |
| Full Name | Ivey Family Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2905 S Walton Blvd., Bentonville, Arkansas |
| Authorized Official Name and Position | Traci Ivey (PROPRIETOR/PHYSICIAN) |
| Authorized Official Contact | 4796576501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivey Family Medicine Po Box 3570 Bentonville AR 72712-7718 Ph: (479) 657-6501 | Ivey Family Medicine 2905 S Walton Blvd. Suite 17 Bentonville AR 72712-7848 Ph: (479) 657-6501 |
| NPI Number | 1932539624 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 11/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932539624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R-4023 (Arkansas) | Primary |
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