Individual
PHILLIP K LOGSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1802 S. MATTIS AVENUE, ORTHOPEDICS, CHAMPAIGN, IL 61821
(217) 383-3260
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003166
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480014262
RAILROAD
IL
Enumeration date
07/20/2006
Last updated
05/07/2014
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