Dr Mark A Herzog, DDS, PA is a
Dentist - General Practice based in Ellsworth, Kansas. Dr Mark A Herzog is licensed to practice in Kansas (license number 6296) and his current practice location is
804 E 8th St, Ellsworth, Kansas. He can be reached at his office (for appointments etc.) via phone at
(785) 472-5420.
NPI number for Dr Mark A Herzog is 1275595290 and his current mailing address is 804 E 8th St, Ellsworth, Kansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1275595290.
Healthcare Provider's Profile
| Full Name | Dr Mark A Herzog |
|---|
| Gender | Male |
|---|
| Speciality | Dentist - General Practice |
|---|
| Location | 804 E 8th St, Ellsworth, Kansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1275595290
- Provider Enumeration Date: 04/05/2006
- Last Update Date: 01/14/2013
Medical Identifiers
Medical identifiers for Dr Mark A Herzog such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275595290 | NPI | - | NPPES |
| 100223300B | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 6296 (Kansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark A Herzog is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mark A Herzog, DDS, PA
804 E 8th St,
Ellsworth, KS 67439-2535
Ph: (785) 472-5420 | Dr Mark A Herzog, DDS, PA
804 E 8th St,
Ellsworth, KS 67439-2535
Ph: (785) 472-5420 |
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