# LOGAN & PETERSON, PC

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

## Provider details

- **NPI number:** 1063613057
- **Authorized official:** DR. STEPHEN E. PETERSON MD.. (VP,TREASURER)
- **Authorized official phone:** (816) 842-2500

## Contact information

- **Practice address:** 428 W 42ND ST, KANSAS CITY, MO 64111-3176
- **Practice address phone:** (816) 842-2500
- **Practice address fax:** (816) 842-9980
- **Mailing address:** 428 W 42ND ST, KANSAS CITY, MO 64111-3176
- **Mailing address phone:** (816) 842-2500
- **Mailing address fax:** (816) 842-9980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | MDR5P | MO | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | R7B57 | MO | — |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 08/22/2020