Individual
LOGAN JOHN SHETLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 W NOBLE ST, LYONS, KS 67554-3026
(620) 257-5124
(620) 257-5128
Mailing address
1221 W NOBLE ST, LYONS, KS 67554-3026
(620) 257-5124
(620) 257-5128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-46362
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2019
Last updated
08/05/2022
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