Provider Demographics
NPI:1407189780
Name:STACEY N. FOLK M.D. P.C.
Entity Type:Organization
Organization Name:STACEY N. FOLK M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-321-6608
Mailing Address - Street 1:4700 HALE PARKWAY
Mailing Address - Street 2:SUITE 520
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-321-6608
Mailing Address - Fax:303-321-7667
Practice Address - Street 1:4700 HALE PARKWAY
Practice Address - Street 2:SUITE 520
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-321-7667
Practice Address - Fax:303-321-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34505237Medicaid