Herzog, Thomas Alexander
Herzog, Thomas Alexander is an individual health care provider with primary practice located at 1600 N Grand Ave Ste 430, Pueblo CO 81003-2700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Herzog, Thomas Alexander can be contacted via phone (719) 545-8240.Contact Information
Primary practice address
1600 N Grand Ave Ste 430
Pueblo CO 81003-2700
Phone: (719) 545-8240
Fax: (719) 545-4319
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 38821 | Colorado |
Profile Details
| NPI number | 1366466526 |
|---|---|
| LBN Legal business name | Herzog, Thomas Alexander |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Aug 2nd, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366466526 | NPPES |
| Colorado | MEDICAID | 81008538 |
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