Provider Demographics
NPI:1124133681
Name:LAPERRIERE, DANIEL CONRAD (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CONRAD
Last Name:LAPERRIERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23500 US HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:WALSENBURG
Mailing Address - State:CO
Mailing Address - Zip Code:81089-9524
Mailing Address - Country:US
Mailing Address - Phone:719-738-5100
Mailing Address - Fax:719-738-5138
Practice Address - Street 1:275 CENTURY CIR STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9453
Practice Address - Country:US
Practice Address - Phone:720-634-3870
Practice Address - Fax:303-209-4645
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41635207Q00000X
CODR.0041635207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO807344Medicare PIN
CO60186259Medicaid