Organization
LOGAN FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE DANIEL LOGAN D.O. (MANAGING MEMBER)
(423) 775-4261
Entity
Organization
Contact information
Practice address
8845 RHEA COUNTY HWY, DAYTON, TN 37321-5926
(423) 775-4261
(423) 775-6988
Mailing address
8845 RHEA COUNTY HWY, DAYTON, TN 37321-5926
(423) 775-4261
(423) 775-6988
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
DO 1846
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511366
—
TN
01
—
4157006
BCBS
TN
01
—
4718093
CIGNA
TN
01
—
DO 1846
TN LICENSE
TN
01
—
PTAN P00416016
MEDICARE RAILROAD
TN
Enumeration date
12/17/2008
Last updated
06/25/2019
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