Logue, Don
Logue, Don is an individual health care provider with primary practice located at 1702 Park Hill Rd , Tahlequah OK 74464-5600. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Logue, Don can be contacted via phone (918) 456-3082.Contact Information
Primary practice address
1702 Park Hill Rd
Tahlequah OK 74464-5600
Phone: (918) 456-3082
Fax: (918) 456-3536
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5234 | Oklahoma |
Profile Details
| NPI number | 1790903011 |
|---|---|
| LBN Legal business name | Logue, Don |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2007 |
| Last updated | Nov 14th, 2013 - about 12 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790903011 | NPPES |
| Oklahoma | MEDICAID | 100091210A |
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