Individual
THOMAS HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2139 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 585-2323
(513) 585-4893
Mailing address
237 WILLIAM HOWARD TAFT, PHYS DIV, CINCINNATI, OH 45219-2906
(513) 585-2323
(513) 585-4893
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
231790-1
NY
207VX0201X
Gynecologic Oncology Physician
Primary
35 057399
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107031
MEDICAID
OH
05
—
02561113
—
NY
01
—
201249540
MEDICAID
IN
01
—
7100315370
MEDICAID
KY
Enumeration date
07/07/2006
Last updated
02/24/2016
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