Individual
LOGAN S JESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220-2093
(317) 338-4200
Mailing address
1001 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220-2093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003377
IN
363A00000X
Physician Assistant
Primary
10003377A
IN
Other
Enumeration date
12/15/2021
Last updated
10/09/2024
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