Individual
KURT KACZANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1250 S WASHINGTON ST, VAN WERT, OH 45891-2551
(419) 238-8620
Mailing address
4147 BEVERLY DR, TOLEDO, OH 43614-5656
(419) 349-6685
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34008562
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34008562
MEDICAL LICENSE
OH
Enumeration date
06/05/2006
Last updated
10/03/2013
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