Individual
DR. GREGORY STEPHEN KACZENSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 SCOTT ST, LITTLE ROCK, AR 72201-4613
(501) 221-7238
(501) 221-7239
Mailing address
1433 KAVANAUGH BLVD, LITTLE ROCK, AR 72205-4323
(501) 221-7238
(501) 221-7239
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
C-5000
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104751001
—
AR
Enumeration date
01/05/2007
Last updated
03/31/2008
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