Individual
VELLORE KIRUBAKARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4121 W 83RD ST, SUITE 254, PRAIRIE VILLAGE, KS 66208-5300
(913) 649-5567
(913) 649-7563
Mailing address
PO BOX 27127, OVERLAND PARK, KS 66225-7127
(913) 649-5567
(913) 649-7563
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-19582
KS
2084P0800X
Psychiatry Physician
35824
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100115600D
—
KS
01
—
11476046
BCBS PROVIDER #
KS
01
—
11476056
BLUE SHIELD KANSAS CITY
KS
05
—
202129227
—
MO
01
—
260036797
RAILROAD MEDICARE
—
01
—
632223
BLUE SHIELD KANSAS
KS
Enumeration date
03/11/2007
Last updated
07/25/2012
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