Logan, Mark

Logan, Mark is an individual health care provider with primary practice located at 1401 Professional Blvd , Evansville IN 47714-8014. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Logan, Mark can be contacted via phone (812) 473-2060.

Contact Information

Primary practice address
1401 Professional Blvd Evansville IN 47714-8014
Phone: (812) 473-2060
Fax: (812) 473-0763
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 32870 Kentucky
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01046534A Indiana

Profile Details

NPI number 1720077407
LBN Legal business name Logan, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Apr 12th, 2024 - about last year

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 1720077407 NPPES
Indiana Other 064945 HEALTH ALLIANCE
Indiana Other 394258 HEALTH ALLIANCE
Indiana MEDICAID 64328701 HEALTH ALLIANCE
Indiana Other 040003023 HEALTH ALLIANCE
Indiana Other P00076697 HEALTH ALLIANCE
Indiana Other 000000045660 HEALTH ALLIANCE
Indiana Other 000000045660 HEALTH ALLIANCE
Indiana MEDICAID 200149220A HEALTH ALLIANCE

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