Healthcare Provider Details

I. General information

NPI: 1235033341
Provider Name (Legal Business Name): ELLIOTT COTTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E 61ST ST N STE 2
PARK CITY KS
67219-1960
US

IV. Provider business mailing address

1106 N 155TH ST STE B
BASEHOR KS
66007-7100
US

V. Phone/Fax

Practice location:
  • Phone: 913-662-7071
  • Fax:
Mailing address:
  • Phone: 816-718-8389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: