Individual
DR. NEVRA SISLI KING-LOGSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1520 S DOBSON RD, SUITE 203, MESA, AZ 85202-4725
(480) 412-8080
(480) 412-6999
Mailing address
8234 E PALM LN, MESA, AZ 85207-9713
(480) 381-7669
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
2009-00154
NC
171000000X
Military Health Care Provider
N1368
TX
207T00000X
Neurological Surgery Physician
Primary
44030
AZ
207T00000X
Neurological Surgery Physician
MD429270
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131011
NEUROSURGERY RESIDENT
NM
Enumeration date
01/24/2007
Last updated
04/10/2017
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