Provider Demographics
NPI:1245433259
Name:DACEY, MARK S (MD)
Entity Type:Individual
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First Name:MARK
Middle Name:S
Last Name:DACEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8101 E LOWRY BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7195
Mailing Address - Country:US
Mailing Address - Phone:303-261-1600
Mailing Address - Fax:303-261-1601
Practice Address - Street 1:11960 LIONESS WAY STE 290
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5640
Practice Address - Country:US
Practice Address - Phone:303-261-1600
Practice Address - Fax:303-261-1601
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-08-07
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Provider Licenses
StateLicense IDTaxonomies
CO49002207WX0108X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02708213Medicaid