| Logan Taylor, CRNA | |
|
20733 N Broad St, Carlinville, IL 62626-1499 | |
| (217) 854-3141 | |
| (217) 625-1005 |
| Full Name | Logan Taylor |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 20733 N Broad St, Carlinville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972962561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209009995 (Illinois) | Primary |
| 363L00000X | Nurse Practitioner | 209.013798 (Illinois) | Secondary |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20031113000382 |
| Entity Name | Salem Township Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295739548 PECOS PAC ID: 0840195277 Enrollment ID: O20031126000688 |
| Entity Name | Anesthesia Associates Of Belleville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932141561 PECOS PAC ID: 5890690812 Enrollment ID: O20031203000567 |
| Entity Name | St Marys Hospital Centralia Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770687196 PECOS PAC ID: 6709788920 Enrollment ID: O20040127000118 |
| Entity Name | Hillsboro Area Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821078213 PECOS PAC ID: 4486547148 Enrollment ID: O20040205000911 |
| Entity Name | Sparta Community Hospital D/b/a Quality Healthcare Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114984226 PECOS PAC ID: 6709870462 Enrollment ID: O20040414000594 |
| Entity Name | Carlinville Area Hospital Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1053425124 PECOS PAC ID: 9032021373 Enrollment ID: O20080422000666 |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20080529000078 |
| Entity Name | G & G Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487020111 PECOS PAC ID: 4981912607 Enrollment ID: O20150930000831 |
| Entity Name | Anesthesia Associates Of Southern Illinois Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043757487 PECOS PAC ID: 0648555433 Enrollment ID: O20170317000152 |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Taylor, CRNA 20733 N Broad St, Carlinville, IL 62626-1499 Ph: (215) 854-3141 | Logan Taylor, CRNA 20733 N Broad St, Carlinville, IL 62626-1499 Ph: (217) 854-3141 |