Organization
HERZOG & HERZOG, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES D. HERZOG PH.D. (CLINICAL PSYCHOLOGIST)
(601) 981-5757
Entity
Organization
Contact information
Practice address
FORTY FIVE HUNDRED INTERSTATE FIFTY FIVE NORTH, 208 HIGHLAND VILLAGE, JACKSON, MS 39211
(601) 981-5757
(601) 981-5494
Mailing address
FORTY-FIVE HUNDRED INTERSATE FIFTY FIVE NORTH, 208 HIGHLAND VILLAGE, JACKSON, MS 39211
(601) 981-5757
(601) 981-5494
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
26348
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
687
ORGANIZATION ID NUMBER
MS
Enumeration date
06/14/2007
Last updated
08/22/2020
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