Provider Demographics
NPI:1194828343
Name:SOUCY, DANA MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARK
Last Name:SOUCY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:101 MEDICAL HEIGHTS DR
Practice Address - Street 2:SUITE F
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4137
Practice Address - Country:US
Practice Address - Phone:502-875-1766
Practice Address - Fax:502-875-5350
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2024-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3647207X00000X
KY40531207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG70211Medicare UPIN