Individual
DR. LEE DANIEL LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8845 RHEA COUNTY HWY, SUITE 101, DAYTON, TN 37321-5926
(423) 775-4261
(423) 757-6988
Mailing address
8845 RHEA COUNTY HWY, DAYTON, TN 37321-5926
(423) 775-4261
(423) 775-6988
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO 1846
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056887
GEORGIA LICENSE
GA
05
—
3300005
—
TN
01
—
4157006
BCBS
TN
01
—
4718093
CIGNA
TN
01
—
DO 1846
TN LICENSE
TN
01
—
PTAN P00416016
MEDICARE RAILROAD
TN
Enumeration date
06/06/2006
Last updated
02/22/2012
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