Basic Information
| Provider Information | |||||||||
| NPI: | 1316975832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRALL | ||||||||
| FirstName: | JOHN ADAIR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7780 S BROADWAY STE 350 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801222641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206387500 | ||||||||
| FaxNumber: | 7205836770 | ||||||||
| Practice Location | |||||||||
| Address1: | 7780 S BROADWAY | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801222648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206387500 | ||||||||
| FaxNumber: | 3036497030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 10/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 36243 | CO | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | DR.0036246 | CO | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 73434256 | 05 | CO | MEDICAID | 01362433 | 05 | CO | MEDICAID |