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Organization
SELF MEDICAL GROUP
Active
Organization
SELF MEDICAL GROUP
Active
Other names
Clinton Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW TOLBERT LOGAN MD (CEO)
(864) 725-4780
Entity
Organization
Contact information
Practice address
22580 HIGHWAY 76 E STE 200, LAURENS, SC 29360-8460
(864) 833-0055
Mailing address
22580 HIGHWAY 76 E STE 200, LAURENS, SC 29360-8460
(864) 833-0055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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