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General NPI Number Information
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NPI Number | 1619909850
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Entity Type | Individual
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Provider Name | THOMAS HERZOG M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 2139 AUBURN AVE
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-585-2323
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Fax | 513-585-4893
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Provider Business Mailing Address
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Address Line | 237 WILLIAM HOWARD TAFT, PHYS DIV
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-585-2323
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Fax | 513-585-4893
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 231790-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 35 057399
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License Number State | OH
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