Individual
DR. JEREMY JAMES LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1460 NE MEDICAL CENTER DR, BEND, OR 97701-6061
(541) 382-6633
(541) 383-4577
Mailing address
1460 NE MEDICAL CENTER DR, BEND, OR 97701-6061
(541) 382-6633
(541) 383-4577
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
81641-20
WI
2085R0202X
Diagnostic Radiology Physician
MD2005-0545
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202003153
PRESBYTERIAN HEALH/SALUD
—
05
—
83852
—
NM
05
—
992108
—
AZ
Enumeration date
02/06/2006
Last updated
04/24/2024
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