Provider Demographics
NPI:1093027203
Name:HERSCH, THOMAS ELLIOT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ELLIOT
Last Name:HERSCH
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1401 ROBERT B MILLER JR RD
Mailing Address - Street 2:165 MDG, BLDG 301
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31408-9001
Mailing Address - Country:US
Mailing Address - Phone:912-966-8531
Mailing Address - Fax:912-966-8593
Practice Address - Street 1:1401 ROBERT B MILLER JR RD
Practice Address - Street 2:165 MDG, BLDG 301
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31408-9001
Practice Address - Country:US
Practice Address - Phone:912-966-8531
Practice Address - Fax:912-966-8593
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2017-04-21
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Provider Licenses
StateLicense IDTaxonomies
GA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant