Provider Demographics
NPI:1649277492
Name:SEBY, MARK V (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:V
Last Name:SEBY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:417 N AGASSIZ ST
Mailing Address - Street 2:BLDG 1
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3206
Mailing Address - Country:US
Mailing Address - Phone:928-779-6169
Mailing Address - Fax:928-779-4200
Practice Address - Street 1:417 N AGASSIZ ST
Practice Address - Street 2:BLDG 1
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3206
Practice Address - Country:US
Practice Address - Phone:928-779-6169
Practice Address - Fax:928-779-4200
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2010-12-30
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Provider Licenses
StateLicense IDTaxonomies
AZZA11476207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ87726OtherUNITED HEALTH CARE
AZ23957601Medicaid
AZ1Z8845OtherHEALTH NET AZ
AZ5447372OtherAETNA
AZZ63389OtherMEDICARE GROUP
AZ1003440OtherCIGNA
AZ71412OtherMUTUAL OF OMAHA
AZ080008588OtherRAILROAD MEDICARE
AZAZ0021730OtherBCBS AZ
AZ1Z8845OtherHEALTH NET AZ
AZ71412OtherMUTUAL OF OMAHA