Individual
ERIC HERROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 HEMLOCK STREET, MACON, GA 31201
(478) 633-6706
(478) 633-5384
Mailing address
598 THIRD STREET, MACON, GA 31201
(478) 633-6706
(478) 633-5384
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN168736
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344331
WELLCARE CMO - MCCG
GA
01
—
P00119008
RAILROAD MCR - MCCG
GA
Enumeration date
05/01/2007
Last updated
07/09/2007
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