Organization
SELF MEDICAL GROUP
Active
Other names
Clinton Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW TOLBERT LOGAN MD (CEO)
(864) 725-4780
Entity
Organization
Contact information
Practice address
22580 HIGHWAY 76 E STE 200, LAURENS, SC 29360-8460
(864) 833-0055
Mailing address
22580 HIGHWAY 76 E STE 200, LAURENS, SC 29360-8460
(864) 833-0055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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