Provider Demographics
NPI:1669663100
Name:KACZMAREK, FRANCIS J (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:J
Last Name:KACZMAREK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2769
Mailing Address - Country:US
Mailing Address - Phone:484-903-9671
Mailing Address - Fax:
Practice Address - Street 1:171 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1708
Practice Address - Country:US
Practice Address - Phone:610-826-7332
Practice Address - Fax:610-824-6564
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-002924-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30066Medicare UPIN