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General NPI Number Information
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NPI Number | 1053318923
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Entity Type | Individual
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Provider Name | BARBARA F KACZMARSKA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 880 COLLOREDO BLVD
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2774
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Country | US
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Telephone | 931-685-8111
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Fax | 931-680-1050
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Provider Business Mailing Address
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Address Line | 880 COLLOREDO BLVD
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2774
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Country | US
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Telephone | 931-685-8111
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Fax | 931-680-1050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | MD28127
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License Number State | TN
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