Individual
LOGAN T SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
943 S BENEVA RD STE 113, SARASOTA, FL 34232-2471
(941) 316-0133
(941) 957-3641
Mailing address
943 S BENEVA RD STE 306, SARASOTA, FL 34232-2499
(941) 955-1108
(941) 954-4440
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0103301320
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4392
FL
213ES0131X
Foot Surgery Podiatrist
0103301320
VA
Other
Enumeration date
04/21/2018
Last updated
10/18/2024
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