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NPI Code Detail

MEDICARE: LAWRENCE J HERBERHOLZ MD

MEDICARE: LAWRENCE J HERBERHOLZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician23961AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
351524140OTHERBLUE CROSS

General Provider Information

NPI Number : 1619977378
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE J HERBERHOLZ MD
Provider Business Mailing Address
First Line : 911 S BROAD ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2509
Country : US
Telephone Number : 256-259-0185
Fax Number : 256-259-0317
Provider Business Practice Location Address
First Line : 911 S BROAD ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2509
Country : US
Telephone Number : 256-259-0185
Fax Number : 256-259-0317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 02/06/2013

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Directions to “ LAWRENCE J HERBERHOLZ MD” Practice Location

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