Jason A. Logan M.D.
Family Medicine Physician in Tulsa, OK(View on Map)
Full Name
Jason A. Logan M.D.
NPI Number
1245220144
NPI Type
Individual Provider
Gender
Male
Enumeration Date
10/24/2005
Specialties
(Taxonomies)Code
207Q00000X
207PE0004X
Primary Taxonomy
Yes
No
Licenses
State
Oklahoma
License Number
22922
Contact
Information
Purpose
Mailing
Location
Address
210 JAMES RD
7600 S LEWIS AVE
City
Bolivar
Tulsa
State
TN
OK
Postal Code
38008-1110
74136-6836
Country
US
US
Telephone Number
(731) 658-5421
(731) 228-9778
Identifiers
Identifier
200018630A
Identifier State
OK
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/30/2010