Individual
DR. LOGAN REX TAYSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
(480) 254-8690
Mailing address
1236 S MARGO DR, TEMPE, AZ 85281-5352
(480) 254-8690
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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