Logan, Jeremy James

Logan, Jeremy James is an individual health care provider with primary practice located at 1460 Ne Medical Center Dr , Bend OR 97701-6061. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Logan, Jeremy James can be contacted via phone (541) 382-6633.

Contact Information

Primary practice address
1460 Ne Medical Center Dr Bend OR 97701-6061
Phone: (541) 382-6633
Fax: (541) 383-4577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 81641-20 Wisconsin
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD2005-0545 New Mexico

Profile Details

NPI number 1053383729
LBN Legal business name Logan, Jeremy James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Apr 24th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053383729 NPPES
New Mexico MEDICAID 83852
New Mexico MEDICAID 992108
New Mexico Other 202003153

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