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Organization

LOGAN VIEW PEDIATRICS

Active
Parent organization
LOGAN VIEW, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
LOGAN VIEW, INC.
Authorized official
TAMARA GUMP (CHIEF OPERATING OFFICER)
(937) 593-0245
Entity
Organization

Contact information

Practice address
118 DOWELL AVE, BELLEFONTAINE, OH 43311-2305
(937) 593-5437
Mailing address
118 DOWELL AVE, BELLEFONTAINE, OH 43311-2305

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
L0893154
OH
Enumeration date
03/25/2006
Last updated
07/11/2007
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