Individual
DR. WILLIAM R LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, STE 5003-B, ST LOUIS, MO 63141
(314) 227-2020
(314) 227-2021
Mailing address
621 S NEW BALLAS RD, STE 5003-B, ST LOUIS, MO 63141
(314) 227-2020
(314) 227-2021
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R1A50
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202000006LO
—
MO
Enumeration date
07/03/2006
Last updated
12/07/2009
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