Individual
LOGAN EMERSON COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 545-8000
Mailing address
PO BOX 19670, SPRINGFIELD, IL 62794-9670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125083506
IL
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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