Individual
JACKSON HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1416 6TH ST SW, MASON CITY, IA 50401-4818
(641) 424-0102
Mailing address
1416 6TH ST SW, MASON CITY, IA 50401-4818
(641) 424-0102
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036178771
IL
2085R0202X
Diagnostic Radiology Physician
Primary
52524
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2015
Last updated
05/14/2026
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