Individual
DR. LOGAN WILLIAM THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 S PALISADE DR STE 208, SANTA MARIA, CA 93454-8906
(805) 922-3632
(805) 922-3522
Mailing address
2285 CORPORATE CIR STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A165505
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2018
Last updated
06/23/2022
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