Individual
WILLIAM A LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOSPITAL DR, MADISONVILLE, KY 42431-1658
(270) 326-4800
(270) 326-4920
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28038
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044296
BCBS PROVIDER NUMBER
—
01
—
28038
LICENSE
KY
05
—
64280381
—
KY
Enumeration date
09/16/2006
Last updated
12/08/2020
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