Individual
THOMAS KAZECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 COUNTRY CLUB RD, LAKE CHARLES, LA 70605
(337) 990-8000
Mailing address
1905 COUNTRY CLUB RD, LAKE CHARLES, LA 70605-5203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
308158
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2014
Last updated
08/27/2018
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