Individual
THOMAS HARRY HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 LYON PLACE, OGDENSBURG, NY 13669
(315) 713-6643
(866) 506-5573
Mailing address
3 LYON PLACE, OGDENSBURG, NY 13669
(315) 394-7542
(866) 506-5573
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
255987
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
ME46735
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03117948
—
NY
05
—
03193937
—
NY
05
—
041980000
—
FL
Enumeration date
05/18/2006
Last updated
10/20/2022
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