Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD28127 | TN |
NPI | 1053318923 |
---|---|
Provider Name | Dr. Barbara F Kaczmarska |
First Address | Shelbyville, TN 37160-2774 |
Second Address | Shelbyville, TN 37160-2774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 15/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3803699 | (05) | TN |
G-37954 | (02) | TN |