Individual
THOMAS ALEXANDER HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 N GRAND AVE, STE 430, PUEBLO, CO 81003-2700
(719) 545-8240
(719) 545-4319
Mailing address
1600 N GRAND AVE, STE 430, PUEBLO, CO 81003-2760
(719) 545-8240
(719) 545-4319
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
38821
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81008538
—
CO
Enumeration date
07/27/2006
Last updated
08/02/2012
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