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MR. MICHAEL KACZKOWSKI

Eye and Vision Services Providers Technician/Technologist Ocularist

Provider NPI: 1417236860

Provider Information:
MR. MICHAEL  KACZKOWSKI 
Gender: M
Not Sole Proprietor

Practice Location:
3924 W MARKHAM ST  LITTLE ROCK, AR 72205 US
Tel: 501-265-0100  Fax: 501-265-0102

Business Mailing Address:
3924 W MARKHAM ST  LITTLE ROCK, AR 72205-5528 US
Tel: 501-265-0100  Fax: 501-265-0102

NPI Information:
NPI: 1417236860
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N156FX1700XEye and Vision Services Providers
Technician/Technologist
Ocularist
Y174400000XOther Service Providers
Specialist
N229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Anaplastologist

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 174400000X

Type:

Classification:



Definition:



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