Provider Demographics
NPI:1215008354
Name:HERZ, WILLIAM STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEVEN
Last Name:HERZ
Suffix:
Gender:M
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:PO BOX 718
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0718
Mailing Address - Country:US
Mailing Address - Phone:541-388-9836
Mailing Address - Fax:541-475-6196
Practice Address - Street 1:125 SW C ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1458
Practice Address - Country:US
Practice Address - Phone:541-475-6575
Practice Address - Fax:541-475-6196
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR118122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR267724Medicaid
ORC91708Medicare UPIN
ORR0000BHSMGMedicare ID - Type Unspecified