MEDICARE: DR. IVY V MCGEE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E-2401	AR
2	207Q00000X	Family Medicine Physician	E2401	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750388401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVY V MCGEE MD

Provider Business Mailing Address
First Line	:	2200 FORT ROOTS DR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1709
Country	:	US
Telephone Number	:	501-257-3934
Fax Number	:	501-257-2026

Provider Business Practice Location Address
First Line	:	2200 FORT ROOTS DR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1709
Country	:	US
Telephone Number	:	501-257-3934
Fax Number	:	501-257-2026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/05/2019

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