DMD Theodore E Logan JR., NPI 1245231778
Oral and Maxillofacial Surgery (Dentist) in Louisville, KY, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1245231778 |
| NPI Entity Type | Individual |
| Provider Name | DMD Theodore E Logan JR. |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 3101 Breckenridge Ln, Ste 2d, Louisville, KY, US |
| Provider Mailing Address | 3101 Breckenridge Ln, Ste 2d, Louisville, KY, US, 402202742 |
| Is Sole Proprietor? | No |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Oral and Maxillofacial Surgery (Dentist) |
| Classification | |
| Group | |
| License No. | 4056 |
| License State | KY |
| Description | The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 64040561 | KY | MEDICAID | 05 |
| 1055007 | KY | PASSPORT | 01 |
| 60040565 | KY | MEDICAID DENTAL | 01 |
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|---|---|---|---|
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M.D. Michael Crum Individual |
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D.O. William B Webb Individual |
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PA-C Brittney R. Judhan Individual |
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MD Brett E Jarrell Individual |
911 Bypass Rd Bldg A |
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APRN Danny Brent Newsome Individual |
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DO John M Fleming Individual |
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