MEDICARE: BARBARA F KACZMARSKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD51897	TN
2	208000000X	Pediatrics Physician	MD28127	TN

General Provider Information

NPI Number	:	1528477056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBARA F KACZMARSKA

Provider Business Mailing Address
First Line	:	880 COLLOREDO BLVD
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-2774
Country	:	US
Telephone Number	:	931-685-8111
Fax Number	:	931-685-8007

Provider Business Practice Location Address
First Line	:	880 COLLOREDO BLVD
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-2774
Country	:	US
Telephone Number	:	931-685-8111
Fax Number	:	931-685-8007

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BARBARA F. KACZMARSKA
Credential	:	MD
Telephone Number	:	931-685-8111

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	09/15/2014

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Directions to “BARBARA F KACZMARSKA ” Practice Location

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