Healthcare Provider Details

I. General information

NPI: 1841322674
Provider Name (Legal Business Name): JOYCE AYCOCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HALE PKWY STE 440
DENVER CO
80220-4000
US

IV. Provider business mailing address

752 S WILLIAMS ST
DENVER CO
80209-4539
US

V. Phone/Fax

Practice location:
  • Phone: 720-634-7400
  • Fax: 720-634-7401
Mailing address:
  • Phone: 773-610-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number46591
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: