Individual
LOGAN D FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 MARSHALL ST STE 500, JACKSON, MS 39202-1615
(601) 948-1411
(601) 948-0090
Mailing address
501 MARSHALL ST STE 500, JACKSON, MS 39202-1615
(601) 948-1411
(601) 948-0090
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
28954
MS
Other
Enumeration date
03/28/2016
Last updated
07/29/2021
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