Individual
DR. LOGAN JAMES MCGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700
(541) 767-5200
(541) 767-5200
Mailing address
13500 AIRPORT RD, BOONVILLE, CA 95415-9133
(707) 895-3477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD181244
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689965204
—
CA
Enumeration date
04/30/2011
Last updated
01/29/2020
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