| John A. Logan College | |
|
700 Logan College Dr Carterville IL 62918-2500 | |
| (618) 985-2828 | |
| (618) 985-4654 |
| Full Name | John A. Logan College |
|---|---|
| Speciality | Dentist |
| Location | 700 Logan College Dr, Carterville, Illinois |
| Authorized Official Name and Position | Pam Ruth Karns (DEPARTMENT CHAIR FOR ALLIED HEALTH) |
| Authorized Official Contact | 6189852828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John A. Logan College 700 Logan College Dr Carterville IL 62918-2500 Ph: (618) 985-2828 | John A. Logan College 700 Logan College Dr Carterville IL 62918-2500 Ph: (618) 985-2828 |
| NPI Number | 1598055741 |
|---|---|
| Provider Enumeration Date | 04/08/2011 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598055741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.018274 (Illinois) | Primary |