Individual
JENNIFER P LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6715 ANTIGUA DR, FORT COLLINS, CO 80525-9433
(970) 372-0696
(970) 372-0696
Mailing address
6715 ANTIGUA DR, FORT COLLINS, CO 80525-9433
(970) 372-0696
(970) 372-0696
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
198357
NY
207W00000X
Ophthalmology Physician
Primary
50382
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01787306
—
NY
Enumeration date
05/23/2005
Last updated
08/25/2011
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