| Vellore Kirubakaran M D P A | |
|
4121 W 83rd St Suite 254 Prairie Village KS 66208-5300 | |
| (913) 649-5567 | |
| (913) 649-7563 |
| Full Name | Vellore Kirubakaran M D P A |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4121 W 83rd St, Prairie Village, Kansas |
| Authorized Official Name and Position | Vellore Kirubakaran (PRESIDENT) |
| Authorized Official Contact | 9136495567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vellore Kirubakaran M D P A Po Box 27127 Overland Park KS 66225-7127 Ph: (913) 649-5567 | Vellore Kirubakaran M D P A 4121 W 83rd St Suite 254 Prairie Village KS 66208-5300 Ph: (913) 649-5567 |
| NPI Number | 1669689188 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 07/25/2012 |
| Medicare PECOS PAC ID | 7618061292 |
|---|---|
| Medicare Enrollment ID | O20070913000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669689188 | NPI | - | NPPES |
| 25463021 | Other | MO | BCBSKC |
| 202129227 | Medicaid | MO | |
| 100115600D | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 04-19582 (Kansas) | Primary |
| Provider Name | Vellore R Kirubakaran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619009172 PECOS PAC ID: 3173617750 Enrollment ID: I20070913000837 |
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