Provider Demographics
NPI:1497084776
Name:LITTLETON SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:LITTLETON SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN ADAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:PRALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-734-8650
Mailing Address - Street 1:5265 SKYTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1566
Mailing Address - Country:US
Mailing Address - Phone:303-734-8650
Mailing Address - Fax:303-734-8653
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 350
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-734-8650
Practice Address - Fax:303-734-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36243207T00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA100408Medicare PIN