Individual
JENNIFER L MACIASZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1210 N WASHINGTON, PLAINVILLE, KS 67663-1632
(785) 434-2622
(785) 434-2577
Mailing address
PO BOX 407, PLAINVILLE, KS 67663-0407
(785) 434-2622
(785) 434-2577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-42574
KS
207Q00000X
Family Medicine Physician
110874
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1646631
—
AK
Enumeration date
05/31/2016
Last updated
09/27/2019
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