Individual
DR. LOGAN ROBERT GORGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 258-1000
(715) 258-1042
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 454-4229
(920) 993-5001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101260237
VA
207P00000X
Emergency Medicine Physician
Primary
74348
WI
Other
Enumeration date
05/13/2014
Last updated
04/29/2021
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