Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 04-29029 | KS |
N | 207RC0000X | Internist - Cardiovascular Disease | 117378 | MO |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 04-29029 | KS |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 117378 | MO |
NPI | 1023067881 |
---|---|
Provider Name | Dr. Dhanunjaya Lakkireddy |
First Address | Kansas City, MO 64151-2411 |
Second Address | Kansas City, KS 66160-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105678 | BCBS KS OUTREACH CLINICS (01) | KS |
200387770A | (05) | KS |
200387770B | (05) | KS |
203747605 | (05) | MO |
37126012 | BCBS KC (01) | MO |