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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

HAZEN TIMOTHY HERZOG, PHYSICIAN ASSISTANT

Active

HAZEN TIMOTHY HERZOG, PHYSICIAN ASSISTANT is a Surgical Physician Assistant healthcare provider located in COOS BAY, Oregon. NPI 1932433190 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · COOS BAY, OR

Registration Details

NPI Number
1932433190
Provider Type
Individual
Gender
Male
NPI Issued
Sep 21, 2009 (16.860671161497 yrs)
Last Updated
Nov 8, 2013
Licenses
7462373-1206 (UT)
PA152638 (OR)

Practice Information

Address
1900 WOODLAND DR
COOS BAY, OR, 974202045
Browse OR providers · Browse ZIP 97420
Phone
5412675151
Fax
5412664501
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Surgical Physician Assistant

Other Surgical Physician Assistant Providers in COOS BAY, OR

Name Credential NPI
CHRISTOPHER HALES RIEHL PA-C 1700112646
BENJAMIN VAL CHU PA-C 1326390121
MATTHEW E CORNIA PA-C 1548705585
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.