| Dr Jacqueline Susan Logan, MD | |
|
2600 Center St Ne, Oregon State Hospital, Salem, OR 97301 | |
| (503) 945-2800 | |
| (503) 945-2807 |
| Full Name | Dr Jacqueline Susan Logan |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Location | 2600 Center St Ne, Salem, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104905108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD20914 (Oregon) | Primary |
| Entity Name | Dhs Office of Financial Services Irs Eopc Bmrc Eotc Osh Osh-p |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508802489 PECOS PAC ID: 0547170383 Enrollment ID: O20040130000453 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jacqueline Susan Logan, MD Po Box 19055, Portland, OR 97280-0055 Ph: (503) 998-6548 | Dr Jacqueline Susan Logan, MD 2600 Center St Ne, Oregon State Hospital, Salem, OR 97301 Ph: (503) 945-2800 |
Brett W Mikeska, M D Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 875 Oak St Se Ste 5070, Salem, OR 97301 Phone: 503-561-8565 Fax: 503-561-8560 |
Dr. Aneet Jyot Deo, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 875 Oak St Se Ste 5070, Salem, OR 97301 Phone: 503-561-8565 Fax: 503-561-8560 |
Ashley Taylor Ott, Internal Medicine Medicare: Medicare Enrolled Practice Location: 875 Oak St Se # C3010, Salem, OR 97301 Phone: 503-399-7520 |
Joseph J Thaler, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 5050 Skyline Village Loop S, Salem, OR 97306 Phone: 503-391-1110 Fax: 503-370-4237 |
Dr. Krystyna Antonina Pekalska, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2400 Lancaster Dr Ne, Salem, OR 97305 Phone: 503-361-5400 |
Dr. Falguny I Bhavan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 875 Oak St Se, Ste 3010, Salem, OR 97301 Phone: 503-399-7520 Fax: 503-362-7344 |
Dr. Douglas Michael Carney, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 960 Liberty St Se Ste 140, Salem, OR 97302 Phone: 503-540-0304 Fax: 503-540-0305 |