Organization
LOGAN HOSPITAL AND MEDICAL CENTER AUTHORITY
Active
Other names
Center for Internal Medicine and Pedicatrics - Academy
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE ROWLEY (CEO)
(405) 260-4191
Entity
Organization
Contact information
Practice address
205 S ACADEMY RD, GUTHRIE, OK 73044-8727
(405) 282-9449
(405) 282-9403
Mailing address
PO BOX 1017, GUTHRIE, OK 73044-1017
(405) 282-9449
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2267
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ5177
MEDICARE RAILROAD
—
Enumeration date
07/13/2005
Last updated
11/15/2007
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