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MR. LOGAN SPENCER MCCARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
424 N BROAD ST, NEW TAZEWELL, TN 37825-6606
(423) 869-7193
Mailing address
PO BOX 367, HARROGATE, TN 37752-0367
(423) 869-7193
(423) 869-7195

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0000017553
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
76170
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q025860
TN
Enumeration date
04/22/2013
Last updated
07/31/2019
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