Provider Demographics
NPI:1265052674
Name:HERWIG, JING XU (MD)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:XU
Last Name:HERWIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JING
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2603 SW 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2628
Mailing Address - Country:US
Mailing Address - Phone:405-378-5752
Mailing Address - Fax:
Practice Address - Street 1:2603 SW 119TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-2628
Practice Address - Country:US
Practice Address - Phone:405-378-5752
Practice Address - Fax:405-378-5753
Is Sole Proprietor?:No
Enumeration Date:2020-04-26
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-10705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine