Organization
VELLORE KIRUBAKARAN M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VELLORE KIRUBAKARAN M.D. (PRESIDENT)
(913) 649-5567
Entity
Organization
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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100115600D
—
KS
05
—
202129227
—
MO
01
—
25463021
BCBSKC
MO
Enumeration date
05/16/2007
Last updated
07/25/2012
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