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 |
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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 |
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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 |