Individual
TANNER A SPEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4742 SW URISH RD, TOPEKA, KS 66610-9758
(785) 220-0780
Mailing address
4742 SW URISH RD, TOPEKA, KS 66610-9758
(785) 220-0780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01901
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002399
MEDICARE PTAN
KS
Enumeration date
04/08/2016
Last updated
07/16/2025
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