Provider Demographics
NPI:1841322674
Name:AYCOCK, JOYCE (MD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:AYCOCK
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 1:752 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4539
Mailing Address - Country:US
Mailing Address - Phone:773-610-6672
Mailing Address - Fax:
Practice Address - Street 1:4600 HALE PKWY STE 440
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4000
Practice Address - Country:US
Practice Address - Phone:720-634-7400
Practice Address - Fax:720-634-7401
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO465912086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61309214Medicaid
COCO300848Medicare PIN