Individual
STACEY M LETTIS LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2925 DEBARR RD, SUITE 230, ANCHORAGE, AK 99508-2959
(907) 777-1800
Mailing address
2925 DEBARR RD, SUITE 230, ANCHORAGE, AK 99508-2959
(907) 777-1800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7772
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1585092
—
AK
Enumeration date
07/02/2008
Last updated
06/29/2016
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