Provider Demographics
NPI:1427055367
Name:PALAZZO, MARK STEVEN (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:PALAZZO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:6622 N 91ST AVE STE 230
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-2570
Practice Address - Country:US
Practice Address - Phone:602-325-2024
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ447088Medicaid
AZAZ0943260OtherBCBS OF ARIZONA
AZ7887069OtherAETNA
AZ25215Medicare ID - Type Unspecified
U73482Medicare UPIN