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Individual

MARK D HERRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7260 HALCYON SUMMIT DR, MONTGOMERY, AL 36117-7047
(334) 277-3332
(334) 277-3522
Mailing address
7260 HALCYON SUMMIT DR, MONTGOMERY, AL 36117-7047
(334) 277-3332
(334) 277-3522

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21157
AL
207NP0225X
Pediatric Dermatology Physician
21157
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529923240
AL
Enumeration date
01/30/2006
Last updated
04/14/2010
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