Provider Demographics
NPI:1013139252
Name:HANDOO, IRFAN (MD)
Entity Type:Individual
Prefix:
First Name:IRFAN
Middle Name:
Last Name:HANDOO
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 1:4474 W. 150TERRACE
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224
Mailing Address - Country:US
Mailing Address - Phone:816-590-1670
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DRIVE, SUITE 329
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-441-9875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100129472084P0800X
KS04-331202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
44236014OtherBCBS
MOA91000002Medicare PIN
44236014OtherBCBS
MOA91B00002Medicare PIN