Logan Grant Mills, MD | |
3401 W Gore Blvd, Lawton, OK 73505-6332 | |
(580) 355-8620 | |
Not Available |
Full Name | Logan Grant Mills |
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Gender | Male |
Speciality | Hospitalist |
Location | 3401 W Gore Blvd, Lawton, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639755101 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | U1966 (Texas) | Secondary |
208M00000X | Hospitalist | 43475 (Oklahoma) | Primary |
Entity Name | Comanche County Healthcare Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053352690 PECOS PAC ID: 0749192433 Enrollment ID: O20031106000742 |
Mailing Address | Practice Location Address |
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Logan Grant Mills, MD 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-1244 | Logan Grant Mills, MD 3401 W Gore Blvd, Lawton, OK 73505-6332 Ph: (580) 355-8620 |
Alexander F Degazon, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 5602 Sw Lee Blvd, Southwest Medical Center, Lawton, OK 73505 Phone: 580-531-4700 | |
Antony Vincent Mancheril, MD Hospitalist Medicare: Not Enrolled in Medicare Practice Location: 3401 W Gore Blvd, Lawton, OK 73505 Phone: 580-355-8620 | |
Pamela J Barry Duguid, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 3201 W Gore Blvd, Suite 202, Lawton, OK 73505 Phone: 580-355-6731 Fax: 580-250-5806 |