# SOUTH LOGAN FAMILY PRACTICE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053519868
- **Authorized official:** VICKI LAWS (OFFICE MANAGER)
- **Authorized official phone:** (303) 733-3764

## Contact information

- **Practice address:** 895 S LOGAN ST, DENVER, CO 80209-4197
- **Practice address phone:** (303) 733-3764
- **Practice address fax:** (303) 733-0868
- **Mailing address:** 895 S LOGAN ST, DENVER, CO 80209-4197
- **Mailing address phone:** (303) 733-3764
- **Mailing address fax:** (303) 733-0868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 26202 | CO | Yes |

## Other

- **Enumeration date:** 07/03/2007
- **Last updated:** 05/06/2009