Provider Demographics
NPI:1912536194
Name:NEUROSURGERY ONE PC
Entity Type:Organization
Organization Name:NEUROSURGERY ONE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
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:720-638-7500
Mailing Address - Street 1:11750 W 2ND PL STE 255
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1726
Mailing Address - Country:US
Mailing Address - Phone:720-638-7500
Mailing Address - Fax:
Practice Address - Street 1:11750 W 2ND PL STE 255
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1726
Practice Address - Country:US
Practice Address - Phone:720-638-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty