Provider Demographics
NPI:1922002351
Name:LAPORTE, JOHANE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANE
Middle Name:
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 DELMONICO DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-0000
Mailing Address - Country:US
Mailing Address - Phone:719-590-9494
Mailing Address - Fax:719-594-9761
Practice Address - Street 1:6615 DELMONICO DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-0000
Practice Address - Country:US
Practice Address - Phone:719-590-9494
Practice Address - Fax:719-594-9761
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95754351Medicaid
COE66196Medicare UPIN
COCM5758Medicare PIN