Individual
MARK WALTER KACZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-0702
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
13525-320
WI
208000000X
Pediatrics Physician
30258
MN
208000000X
Pediatrics Physician
67759
MN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
67759
MN
Other
Enumeration date
04/29/2019
Last updated
08/11/2025
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