Individual
BRIAN J LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2907 S MCINTIRE DR, BLOOMINGTON, IN 47403-4224
(812) 332-8765
(812) 336-3425
Mailing address
2907 MCINTYRE DR, BLOOMINGTON, IN 47403-4209
(812) 332-8765
(812) 336-3425
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01037620A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100167090
—
IN
Enumeration date
07/11/2005
Last updated
02/18/2025
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