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Individual

SCOTT D LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2640
(740) 356-8117
(740) 353-1214
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-8681
(740) 356-7900

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35077928
OH
2085R0202X
Diagnostic Radiology Physician
MC-167
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2207472
OH
05
64029481
KY
01
P00187419
SOM RR MDCR PIN NO
OH
Enumeration date
07/22/2005
Last updated
03/25/2024
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