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Individual

DR. ANTHONY THOMAS KACZMAREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1428 EAST 72HIGHWAY, ROLLA, MO 65401
(573) 364-1014
(573) 364-6872
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-1014
(573) 364-6872

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10031
MO
208800000X
Urology Physician
110031
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208305102
MO
Enumeration date
04/28/2006
Last updated
03/02/2026
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