Provider Demographics
NPI:1548799976
Name:HERZOG, ALEXANDER MADDOX (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:MADDOX
Last Name:HERZOG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4791
Mailing Address - Country:US
Mailing Address - Phone:404-255-9100
Mailing Address - Fax:404-257-7171
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4791
Practice Address - Country:US
Practice Address - Phone:404-255-9100
Practice Address - Fax:404-257-7171
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA009059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine