# LARISA KACHOWSKI, MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Larisa Kachowski Family Medicine, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376001172
- **Authorized official:** LARISA KACHOWSKI MD (OWNER)
- **Authorized official phone:** (501) 502-4071

## Contact information

- **Practice address:** 1726 W 42D AVE, PINE BLUFF, AR 71603-7160
- **Practice address phone:** (501) 502-4071
- **Mailing address:** 3 STRATFORD LN, PINE BLUFF, AR 71603-7527
- **Mailing address phone:** (501) 502-4071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2019
- **Last updated:** 04/01/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1023214574 | NPPES | AR |