| Dr Louis Jack Herskowitz, MD | |
| 
					1790 Mulkey Rd, Suite 1, Austell, GA 30106-1122  | |
| (770) 941-1013 | |
| (770) 941-9418 | 
| Full Name | Dr Louis Jack Herskowitz | 
|---|---|
| Gender | Male | 
| Speciality | Dermatology | 
| Location | 1790 Mulkey Rd, Austell, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972561819 | NPI | - | NPPES | 
| D29820 | Other | GA | PIN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207N00000X | Dermatology | 020546 (Georgia) | Primary | 
| Entity Name | Aqua Dermatology Of Georgia Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1114022167 PECOS PAC ID: 6800885757 Enrollment ID: O20040507000201  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Louis Jack Herskowitz, MD 835 Cogburn Avenue Nw, Suite 250, Marietta, GA 30060-1031 Ph: (770) 422-8815  | Dr Louis Jack Herskowitz, MD 1790 Mulkey Rd, Suite 1, Austell, GA 30106-1122 Ph: (770) 941-1013  | 
Latrice M Hogue, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 770-732-1137 Fax: 770-732-2081  | |
Ms. Lauren I Henderson, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 707-321-1377 Fax: 770-732-2081  | |
Janice Murphy Warner, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 404-446-1440 Fax: 770-732-2081  | |
Kerrie Grunnet Satcher, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1550 Mulkey Rd, Austell, GA 30106 Phone: 770-732-1137 Fax: 770-732-2081  |