Provider Demographics
NPI:1730159369
Name:SACKS, HERMAN MARX (DO)
Entity type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:MARX
Last Name:SACKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15571 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-6078
Mailing Address - Country:US
Mailing Address - Phone:228-209-0928
Mailing Address - Fax:
Practice Address - Street 1:3661 SANGANI BLVD STE E
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-8707
Practice Address - Country:US
Practice Address - Phone:228-354-0022
Practice Address - Fax:228-354-0088
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine