Provider Demographics
NPI:1447253893
Name:HUNSICKER, LISA M (MD, FACS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:HUNSICKER
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 S BROADWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122
Mailing Address - Country:US
Mailing Address - Phone:720-283-2500
Mailing Address - Fax:720-283-1122
Practice Address - Street 1:7750 S BROADWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:720-283-2500
Practice Address - Fax:720-283-1122
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36965208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH40529Medicare UPIN
COC543358Medicare UPIN