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Individual

MR. JON ANDREW LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
621 NORTH AVE, STE. C-30, ATLANTA, GA 30354-1430
(678) 904-6820
Mailing address
214 SUTTON RD, TIFTON, GA 31794-2221
(229) 382-2827

Taxonomy

Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
309371
GA
363A00000X
Physician Assistant
Primary
06WI1204
GA

Other

Enumeration date
06/27/2007
Last updated
09/11/2025
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