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Organization

SELF REGIONAL HEALTHCARE

Active
Other names
Lakelands Neurology, Self Regional Neurology
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW TOLBERT LOGAN (PRESIDENT & CEO)
(864) 725-4780
Entity
Organization

Contact information

Practice address
102 KATIE CT, GREENWOOD, SC 29646-4068
(864) 725-7800
Mailing address
104 WELLS AVE, GREENWOOD, SC 29646-3837
(864) 725-4673
(864) 725-7424

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
2084A2900X
Neurocritical Care Physician
2084E0001X
Epilepsy Physician
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
10/28/2025
Last updated
07/13/2026
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