Individual
DR. LOGAN REX TAYSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
1625 N CAMPBELL AVE, TUCSON, AZ 85719-4330
(520) 694-0111
Mailing address
4025 W BORAS MINE CT, TUCSON, AZ 85745-4196
(480) 254-8690
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
79111
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
06/01/2026
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