Mark D. Herron, M.D. L.L.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

21157 Issued in AL

Legal business name

MARK D. HERRON, M.D. L.L.C.

Practice address

7260 Halcyon Summit Dr
Montgomery, AL 36117-7047

Phone

(334) 277-3332

Fax

(334) 277-3522

NPI assigned

Jan 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Meredith Daffin

Title

Administrator

Phone

(334) 272-7273

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark D Herron, M.D.

  • Dermatology Physician
  • Montgomery, AL
  • NPI 1942271812
  Medicare reassignment Care Compare group NPD
• Kelli Knox Riddle, PA

  • Physician Assistant
  • Auburn, AL
  • NPI 1801938394
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1104897073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 HALCYON SUMMIT DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177047",
            "telephone_number": "334-277-3332",
            "fax_number": "334-277-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 HALCYON SUMMIT DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177047",
            "telephone_number": "334-277-3332",
            "fax_number": "334-277-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D. HERRON, M.D. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "DAFFIN",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-272-7273"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "21157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529923240",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wickliffe J Many Jr., M.D.
• Margaret A March-Phillips, DDS
• Marguerite J. Barber-Owens
• Marilyn Sledge Jackson/Safe Harbor
• Marimat Language Solutions LLC
• Mark S Veres DPM
• Ann S. Markham, R.PH.
• Kimberly Marks
• Crista Wanda Marquardt, C.R.N.A.
• John Jerry Marsella Jr., MD

• Dermatology Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.