Organization
LOGAN PHYSICIAN PRACTICE, LLC
Active
Other names
Auburn Community Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J TEAGUE (VICE PRESIDENT AND CORP SECRETARY)
(629) 253-5121
Entity
Organization
Contact information
Practice address
128 SUGAR MAPLE DRIVE, AUBURN, KY 42206
(615) 957-0847
Mailing address
128 SUGAR MAPLE DRIVE, AUBURN, KY 42206
(615) 957-0847
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/17/2010
Last updated
07/03/2024
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