Provider Demographics
NPI:1447282413
Name:SEGNITZ, HERBERT (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:SEGNITZ
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 1:614 CENTRAL CENTER
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601
Mailing Address - Country:US
Mailing Address - Phone:740-774-9927
Mailing Address - Fax:740-774-9929
Practice Address - Street 1:614 CENTRAL CENTER
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:740-774-9927
Practice Address - Fax:740-774-9929
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0891496Medicaid
OH0733186Medicare ID - Type Unspecified
E96126Medicare UPIN