Herzog, John L

Herzog, John L is an sole proprietor health care provider with primary practice located at 1421 E Union St , Greenville MS 38703-3247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Herzog, John L can be contacted via phone (662) 335-0183.

Contact Information

Primary practice address
1421 E Union St Greenville MS 38703-3247
Phone: (662) 335-0183
Fax: (662) 335-7184
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 09800 Mississippi

Profile Details

NPI number 1093734949
LBN Legal business name Herzog, John L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated Aug 21st, 2020 - about 5 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093734949 NPPES
Mississippi Other 060000624 MEDICARE
Mississippi MEDICAID 00123017 MEDICARE
Mississippi MEDICAID 126236001 MEDICARE

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