Provider Demographics
NPI:1295146132
Name:NEUROSURGERY ONE PC
Entity type:Organization
Organization Name:NEUROSURGERY ONE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:ADAIR
Authorized Official - Last Name:PRALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-638-7500
Mailing Address - Street 1:1400 S POTOMAC ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4528
Mailing Address - Country:US
Mailing Address - Phone:720-638-7500
Mailing Address - Fax:303-586-2292
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:720-638-7500
Practice Address - Fax:303-586-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty