Provider Demographics
NPI:1598750986
Name:HERRON, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:HERRON
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 1:520 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1038
Mailing Address - Country:US
Mailing Address - Phone:812-885-3344
Mailing Address - Fax:812-885-3811
Practice Address - Street 1:520 S 7TH ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1038
Practice Address - Country:US
Practice Address - Phone:812-885-3344
Practice Address - Fax:812-885-3811
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057599A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL003230OtherHEALTH ALLIANCE
IL036107791Medicaid
IL624302OtherHEALTHLINK
IN200450570Medicaid
IL2168888OtherUNITED HEALTHCARE
IL5132004OtherBLUECROSS BLUESHIELD
IL1729885OtherFIRST HEALTH
IN200450570Medicaid
IL003230OtherHEALTH ALLIANCE
IL2168888OtherUNITED HEALTHCARE
INH55945Medicare UPIN
IL624302OtherHEALTHLINK