LOGAN FAMILY MEDICAL CENTER LLC NPI 1285824979

NPI Information

LOGAN FAMILY MEDICAL CENTER LLC is a primary care clinic center in Bellefontaine, OH. LOGAN FAMILY MEDICAL CENTER LLC NPI is 1285824979. The provider is registered as an organization entity type.

The provider's business location address is:

2210 TIMBER TRL
BELLEFONTAINE, OH
ZIP 43311-039
Phone: (937) 593-3151

The provider's authorized official is Mabbu G Shivaprasad .
The authorized official title is Physician and has the following contact phone number (937) 593-3151.

The CLIA number assigned to this NPI record is 36D0977155 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2007 and was last updated on 7/28/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.