Individual
JARED LANCE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
Mailing address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
05-37913
KS
208M00000X
Hospitalist Physician
Primary
05-37913
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002331
MEDICARE PTAN
KS
05
—
201117930A
—
KS
05
—
30004382360001
—
KS
Enumeration date
06/16/2012
Last updated
11/06/2025
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