Mary Street Logan, MD is a
Anesthesiology physician based in Thomaston, Georgia. Mary Street Logan is licensed to practice in Georgia (license number 040466) and her current practice location is 801 W Gordon St, Thomaston, Georgia. She can be reached at her office (for appointments etc.) via phone at
(706) 647-8111.
NPI number for Mary Street Logan is 1225021918 and her current mailing address is Po Box 589, Thomaston, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1225021918.
Physician's Profile
| Full Name | Mary Street Logan |
|---|
| Gender | Female |
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| Speciality | Anesthesiology |
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| Location | 801 W Gordon St, Thomaston, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1225021918
- Provider Enumeration Date: 08/26/2005
- Last Update Date: 03/03/2010
Medical Identifiers
Medical identifiers for Mary Street Logan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225021918 | NPI | - | NPPES |
| P00144203 | Other | | RAILROAD MEDICARE |
| 183893252B | Medicaid | GA | |
| 925994 | Other | | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 040466 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Street Logan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary Street Logan, MD
Po Box 589,
Thomaston, GA 30286-0008
Ph: (706) 647-8111 | Mary Street Logan, MD
801 W Gordon St,
Thomaston, GA 30286-3426
Ph: (706) 647-8111 |
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