| Logan Gibson, MD | |
| 10465 Park Meadows Dr, Lone Tree, CO 80124-5319 | |
| (303) 790-1515 | |
| Not Available | 
| Full Name | Logan Gibson | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics - Pediatric Gastroenterology | 
| Location | 10465 Park Meadows Dr, Lone Tree, Colorado | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1083009468 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | DR.0066040 (Colorado) | Primary | 
| Entity Name | Obstetrix Medical Group Of Colorado P C | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1497779276 PECOS PAC ID: 6709776651 Enrollment ID: O20040316001040 | 
| Entity Name | Healthone Clinic Services - Pediatric Specialties Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720293251 PECOS PAC ID: 2365535572 Enrollment ID: O20070904000695 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Logan Gibson, MD 6427 Oakbrook Dr, Ypsilanti, MI 48197-9494 Ph: (316) 304-2976 | Logan Gibson, MD 10465 Park Meadows Dr, Lone Tree, CO 80124-5319 Ph: (303) 790-1515 | 
| Emily Jeanne Vangeti, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10099 Ridgegate Pkwy Ste 290, Lone Tree, CO 80124 Phone: 303-803-1005 Fax: 303-798-3248 | |
| Nancy Anne Taoka, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10099 Ridgegate Pkwy Ste 290, Lone Tree, CO 80124 Phone: 303-803-1005 Fax: 303-798-3248 | |
| Dr. Theodore Harry Stathos, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9224 Teddy Lane, Suite 200, Lone Tree, CO 80124 Phone: 303-790-1515 Fax: 303-790-1989 | |
| Robert A Kilpatrick,  Pediatrics Medicare: Medicare Enrolled Practice Location: 10101 Ridgegate Pkwy, Lone Tree, CO 80124 Phone: 720-225-1000 Fax: 303-306-7753 | |
| Dr. Matthew J Hadeed, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 10099 Ridgegate Pkwy Ste 290, Lone Tree, CO 80124 Phone: 303-803-1005 Fax: 303-798-3248 | |
| Dr. Ronald Dean Holmes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9224 Teddy Ln, #200, Lone Tree, CO 80124 Phone: 303-869-2121 Fax: 303-860-1597 |