Individual
MARK A HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12094 MONTGOMERY RD, CINCINNATI, OH 45249-1729
(513) 774-0999
(513) 774-0547
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4746 / T1550
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122749
ANTHEM
OH
01
—
311645431
U.H.C.
—
Enumeration date
08/30/2006
Last updated
06/24/2024
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