Provider Demographics
NPI:1477751717
Name:MARKS, ALICIA GRACE (DO)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:GRACE
Last Name:MARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:GRACE
Other - Last Name:BALOGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:#510E
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2803
Mailing Address - Country:US
Mailing Address - Phone:303-783-3883
Mailing Address - Fax:303-783-3800
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:#510E
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-783-3883
Practice Address - Fax:303-783-3800
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY032892080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100148210Medicaid