Individual
LOGAN MATTHEW ATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2106 LOOP RD, WINNSBORO, LA 71295-3344
(318) 412-5265
Mailing address
PO BOX 1300, WINNSBORO, LA 71295-1300
(318) 435-9411
(318) 435-3842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
206654
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12666818
CAQH
—
05
—
2188208
—
LA
01
—
71JC5
MEDICARE
LA
01
—
P01583382
RR MEDICARE
LA
Enumeration date
04/17/2012
Last updated
04/08/2021
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