Provider Demographics
NPI:1235124298
Name:VELAKATURI, VINOD (MD)
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:
Last Name:VELAKATURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 STATE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2815
Mailing Address - Country:US
Mailing Address - Phone:913-335-6986
Mailing Address - Fax:855-446-7151
Practice Address - Street 1:7527 STATE AVE STE 100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2815
Practice Address - Country:US
Practice Address - Phone:913-335-6986
Practice Address - Fax:855-446-7151
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-26600207R00000X
MOMD 112407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209718808Medicaid
KS100452400AMedicaid
KS100452400AMedicaid
MO209718808Medicaid