Provider Demographics
NPI:1528017639
Name:LAPRADE, PAUL WHITMER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WHITMER
Last Name:LAPRADE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:6036 N 19TH AVE
Mailing Address - Street 2:# 504
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015
Mailing Address - Country:US
Mailing Address - Phone:602-242-0299
Mailing Address - Fax:602-242-9429
Practice Address - Street 1:6036 N 19TH AVE
Practice Address - Street 2:# 504
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015
Practice Address - Country:US
Practice Address - Phone:602-242-0299
Practice Address - Fax:602-242-9429
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2007-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ13306207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z0000BGKPCMedicare PIN
C99837Medicare UPIN