MEDICARE: DR. JOHANE LAPORTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	33464	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922002351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHANE LAPORTE MD

Provider Business Mailing Address
First Line	:	6615 DELMONICO DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-0000
Country	:	US
Telephone Number	:	719-590-9494
Fax Number	:	719-594-9761

Provider Business Practice Location Address
First Line	:	6615 DELMONICO DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-0000
Country	:	US
Telephone Number	:	719-590-9494
Fax Number	:	719-594-9761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/29/2008

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