Individual
DR. ANASTACIO G HERRERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 GRANT LN, COLUMBIA, KY 42728-2233
(270) 384-6066
(270) 384-2057
Mailing address
40 GRANT LN, COLUMBIA, KY 42728-2233
(270) 384-6066
(270) 384-2057
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
21312
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049321
ANTHEM PROVIDER NUMBER
KY
01
—
611169409-00
CHAMPUS PROVIDER NUMBER
KY
05
—
64213127
—
KY
01
—
TWCC611169409
WORKMAN'S COMP PROVIDER #
KY
Enumeration date
08/02/2005
Last updated
06/07/2012
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