Healthcare Provider Details

I. General information

NPI: 1558572628
Provider Name (Legal Business Name): KARI C FARRIS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9209 W 110TH ST
OVERLAND PARK KS
66210-1401
US

IV. Provider business mailing address

9209 W 110TH ST
OVERLAND PARK KS
66210
US

V. Phone/Fax

Practice location:
  • Phone: 913-735-4726
  • Fax: 913-428-7195
Mailing address:
  • Phone: 913-735-4726
  • Fax: 913-428-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2010014077
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number05-38929
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number5101016898
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: