Thomas Alexander Herzog, MD | |
1600 N Grand Ave, Ste 430, Pueblo, CO 81003-2700 | |
(719) 545-8240 | |
(719) 545-4319 |
Full Name | Thomas Alexander Herzog |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 29 Years |
Location | 1600 N Grand Ave, Pueblo, Colorado |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366466526 | NPI | - | NPPES |
81008538 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 38821 (Colorado) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Parkview Medical Center, Inc | Pueblo, CO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Parkview Ancillary Services Corporation | 4385722511 | 265 |
Entity Name | Sangre De Cristo Surgical Associates Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184645418 PECOS PAC ID: 8224927801 Enrollment ID: O20040311001470 |
Entity Name | Parkview Ancillary Services Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982878765 PECOS PAC ID: 4385722511 Enrollment ID: O20080429000248 |
Mailing Address | Practice Location Address |
---|---|
Thomas Alexander Herzog, MD 1600 N Grand Ave, Ste 430, Pueblo, CO 81003-2760 Ph: (719) 545-8240 | Thomas Alexander Herzog, MD 1600 N Grand Ave, Ste 430, Pueblo, CO 81003-2700 Ph: (719) 545-8240 |
Dr. Paul Raymond Radway, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3506 San Jose Ct, Pueblo, CO 81005 Phone: 719-252-6467 | |
Michael Lee King, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1600 N Grand Ave, Ste 510, Pueblo, CO 81003 Phone: 719-566-3535 Fax: 719-566-3565 | |
Dr. Rina K. Shinn, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1600 W 24th St, Pueblo, CO 81003 Phone: 719-546-4947 | |
Dr. Lonnie L Imlay, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1925 E. Orman Ave., Suite A109, Pueblo, CO 81004 Phone: 719-564-0210 Fax: 719-564-9483 | |
Priscilla Nobecourt, Surgery Medicare: Accepting Medicare Assignments Practice Location: 1600 N Grand Ave Ste 430, Pueblo, CO 81003 Phone: 719-545-8240 | |
Philip Charles Marin, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1304 N Grand Ave, Pueblo, CO 81003 Phone: 719-669-8487 Fax: 719-669-8488 | |
Maryam Idrees Khan, MD Surgery Medicare: Medicare Enrolled Practice Location: 1600 N Grand Ave Ste 430, Pueblo, CO 81003 Phone: 719-545-8240 Fax: 719-545-4319 |