Provider Demographics
NPI:1851367015
Name:YARUS, LANCE O (DO)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:O
Last Name:YARUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410-12 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5351
Mailing Address - Country:US
Mailing Address - Phone:717-274-3693
Mailing Address - Fax:717-273-0152
Practice Address - Street 1:410-12 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5314
Practice Address - Country:US
Practice Address - Phone:717-274-3693
Practice Address - Fax:717-273-0152
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004974L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011955790003Medicaid
PA470519EV2Medicare ID - Type Unspecified
PA0011955790003Medicaid