Provider Demographics
NPI:1699745836
Name:LOUCKS, DAVID CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CRAIG
Last Name:LOUCKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 S YOSEMITE ST
Mailing Address - Street 2:220
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3191
Mailing Address - Country:US
Mailing Address - Phone:303-699-7325
Mailing Address - Fax:303-659-5287
Practice Address - Street 1:9777 S YOSEMITE ST
Practice Address - Street 2:220
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-3191
Practice Address - Country:US
Practice Address - Phone:303-699-7325
Practice Address - Fax:303-659-5287
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40906207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89939221Medicaid
CO804782Medicare PIN
CO89939221Medicaid