Provider Demographics
NPI:1093937468
Name:HERRON, MARGO S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:S
Last Name:HERRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1887
Mailing Address - Country:US
Mailing Address - Phone:541-708-5433
Mailing Address - Fax:541-708-5434
Practice Address - Street 1:638 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1887
Practice Address - Country:US
Practice Address - Phone:541-708-5433
Practice Address - Fax:541-708-5434
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD153865208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500636211Medicaid