Herzog, Jacques A
Herzog, Jacques A is an individual health care provider with primary practice located at 450 N New Ballas Rd Dept Otolaryngology, Ste 140, Saint Louis MO 63141-6859. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otology & Neurotology. Allopathic & Osteopathic Physicians / Otology & Neurotology is his primary health care specialty. Herzog, Jacques A can be contacted via phone (314) 362-7509.Contact Information
Primary practice address
450 N New Ballas Rd Dept Otolaryngology, Ste 140
Saint Louis MO 63141-6859
Phone: (314) 362-7509
Fax: (314) 453-0561
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | R7F68 | Missouri |
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | R7F68 | Missouri |
Profile Details
| NPI number | 1255330650 |
|---|---|
| LBN Legal business name | Herzog, Jacques A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Apr 25th, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255330650 | NPPES |
| Missouri | MEDICAID | 202326427 |
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