Individual
ANDREA F LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1129 OCEAN SPRINGS RD, OCEAN SPRINGS, MS 39564-3421
(228) 818-5008
(228) 818-5012
Mailing address
1129 OCEAN SPRINGS RD, OCEAN SPRINGS, MS 39564-3421
(228) 818-5008
(228) 818-5012
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21719
MS
208000000X
Pediatrics Physician
AU5009697 1339
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08607835
—
MS
01
—
21719
STATE MEDICAL LICENSE
MS
Enumeration date
07/09/2008
Last updated
02/04/2020
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