| Dr John Landiss Logan, MD | |
|
2005 E 18th Ave, Denver, CO 80206-1109 | |
| (303) 321-4212 | |
| (303) 388-2459 |
| Full Name | Dr John Landiss Logan |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 2005 E 18th Ave, Denver, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124020771 | NPI | - | NPPES |
| 01322007 | Medicaid | CO | |
| 340012614 | Other | CO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 32200 (Colorado) | Primary |
| Entity Name | Rocky Mountain Lithotripter Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134202435 PECOS PAC ID: 5395737985 Enrollment ID: O20040401001756 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Landiss Logan, MD 2005 E 18th Ave, Denver, CO 80206-1109 Ph: (303) 321-4212 | Dr John Landiss Logan, MD 2005 E 18th Ave, Denver, CO 80206-1109 Ph: (303) 321-4212 |
Dr. John William Tillett, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 850 E Harvard Ave Ste 305, Denver, CO 80210 Phone: 303-825-8822 Fax: 303-825-4022 | |
Dr. Dustin R Ridout, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 10350 E Dakota Ave, Denver, CO 80247 Phone: 303-338-4545 | |
Milford Ray Painter Jr., Urology Medicare: Not Enrolled in Medicare Practice Location: 2635 Walnut St, Denver, CO 80205 Phone: 877-320-1692 | |
Dr. Michael E Chen, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 10350 E Dakota Ave, Denver, CO 80247 Phone: 303-338-4545 | |
Dr. Benjamin Carpenter, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2777 Mile High Stadium Cir, Denver, CO 80211 Phone: 303-825-8822 Fax: 303-825-4022 | |
Kyle Walker Szymanski, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 777 Bannock St, Denver, CO 80204 Phone: 303-602-7600 Fax: 303-602-7601 |