Hazen Timothy Herzog, PHYSICIAN ASSISTANT

NPI #1932433190 in Coos Bay, Oregon

Provider Information

NPI Number
1932433190
Entity Type
Individual
Name
Hazen Timothy Herzog, PHYSICIAN ASSISTANT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Surgical
Credential
PHYSICIAN ASSISTANT
Enumeration Date
Sep 21, 2009
Last Updated
Nov 8, 2013

Practice Location

Address
1900 WOODLAND DR
State
Oregon
ZIP Code
97420-2045
Phone
(541) 267-5151

Specialties & Taxonomy Codes

Specialty
Physician Assistant
Physician Assistant - SurgicalSurgical

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