Provider Demographics
NPI:1992813034
Name:FOLK, STACEY N (MD)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:N
Last Name:FOLK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:303-321-6608
Practice Address - Fax:303-321-7667
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35949208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC30421Medicare PIN
COC30421Medicare UPIN