Provider Demographics
NPI:1558572628
Name:FARRIS, KARI C (DO)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:C
Last Name:FARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9209 W 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210
Mailing Address - Country:US
Mailing Address - Phone:913-735-4726
Mailing Address - Fax:913-428-7195
Practice Address - Street 1:9209 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1401
Practice Address - Country:US
Practice Address - Phone:913-735-4726
Practice Address - Fax:913-428-7195
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014077207V00000X
KS05-38929207V00000X
MI5101016898207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO44102013OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY
MOY36000036Medicare PIN