Individual
LOGAN ALAN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10315 DAWSONS CREEK BLVD STE B, FORT WAYNE, IN 46825
(260) 436-7875
Mailing address
10315 DAWSONS CREEK BLVD STE B, FORT WAYNE, IN 46825-1912
(260) 436-7875
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28247885A
IN
Other
Enumeration date
12/18/2018
Last updated
02/02/2019
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