Individual
MRS. MARY CAROLINE LOGHRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 N WILLOW AVE, COOKEVILLE, TN 38501-2368
(931) 528-1485
(931) 526-4233
Mailing address
150 N WILLOW AVE, COOKEVILLE, TN 38501-2368
(931) 528-1485
(931) 526-4233
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41159
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517710
—
TN
01
—
1538173471
COOKEVILLE PEDIATRIC ASSOCIATES NPI
TN
01
—
4130317
BCBS
TN
05
—
5440812
—
TN
Enumeration date
07/07/2006
Last updated
03/22/2011
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