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General NPI Number Information
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NPI Number | 1497084776
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Entity Type | Organization
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Legal Business Name | LITTLETON SURGICAL SERVICES LLC
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 7780 S BROADWAY SUITE 350
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City | LITTLETON
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State | CO
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Zip | 80122-2648
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Country | US
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Telephone | 303-734-8650
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Fax | 303-734-8653
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Provider Business Mailing Address
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Address Line | 5265 SKYTRAIL DR
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City | LITTLETON
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State | CO
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Zip | 80123-1566
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Country | US
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Telephone | 303-734-8650
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Fax | 303-734-8653
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ADAIR PRALL
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Credential | M.D.
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Telephone | 303-734-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 36243
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 36243
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License Number State | CO
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