MEDICARE: DR. BARBARA F KACZMARSKA M.D.

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	2080A0000X	Pediatric Adolescent Medicine Physician	MD28127	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053318923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA F KACZMARSKA M.D.

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	:	931-680-1050

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	:	931-680-1050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/15/2014

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