Individual
MR. LOGAN HAYES WEATHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NEURPHYSIOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.010990
IL
246ZC0007X
Surgical Assistant
26-237
IL
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
363AS0400X
Surgical Physician Assistant
Primary
238.010990
IL
363AS0400X
Surgical Physician Assistant
Primary
26-237
IL
Other
Enumeration date
12/14/2022
Last updated
06/24/2026
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