| Logan Family Practice Llc | |
|
1719 Nashville St Ste C Russellville KY 42276-7804 | |
| (270) 726-7664 | |
| Not Available |
| Full Name | Logan Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1719 Nashville St Ste C, Russellville, Kentucky |
| Authorized Official Name and Position | Kathy Teague (AVP, SECRETARY) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Family Practice Llc 330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | Logan Family Practice Llc 1719 Nashville St Ste C Russellville KY 42276-7804 Ph: (270) 726-7664 |
| NPI Number | 1699447169 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 10/01/2021 |
| Medicare PECOS PAC ID | 7719384163 |
|---|---|
| Medicare Enrollment ID | O20220601002036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699447169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Logan Family Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1719 Nashville St, Russellville, KY 42276 Phone: 270-726-7664 | |
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