Provider Demographics
NPI:1194154179
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 1:7780 S BROADWAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2648
Mailing Address - Country:US
Mailing Address - Phone:720-638-7500
Mailing Address - Fax:720-583-6770
Practice Address - Street 1:9980 PARK MEADOWS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6739
Practice Address - Country:US
Practice Address - Phone:720-638-7500
Practice Address - Fax:720-583-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty