Provider Demographics
NPI:1316975832
Name:PRALL, JOHN ADAIR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN ADAIR
Middle Name:
Last Name:PRALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7780 S BROADWAY STE 350
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2641
Mailing Address - Country:US
Mailing Address - Phone:720-638-7500
Mailing Address - Fax:720-583-6770
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:303-649-7030
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0036246207T00000X
CO36243207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73434256Medicaid
CO01362433Medicaid
COC543378Medicare PIN
CO73434256Medicaid
COC477738Medicare PIN
COCOA100408Medicare PIN