| Logan Family Medicine | |
|
298 Lincoln St Sw Concord NC 28025-5469 | |
| (704) 920-1065 | |
| (704) 792-2272 |
| Full Name | Logan Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 298 Lincoln St Sw, Concord, North Carolina |
| Authorized Official Name and Position | Don Holloman (CEO) |
| Authorized Official Contact | 7047922203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Family Medicine 298 Lincoln St Sw Concord NC 28025-5469 Ph: (704) 920-1065 | Logan Family Medicine 298 Lincoln St Sw Concord NC 28025-5469 Ph: (704) 920-1065 |
| NPI Number | 1689870941 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 10/07/2022 |
| Medicare PECOS PAC ID | 9638197635 |
|---|---|
| Medicare Enrollment ID | O20061227000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689870941 | NPI | - | NPPES |
| 344534C | Medicaid | NC | |
| 344534A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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