| Logan Medical Clinic | |
|
214 W Main St Logan KS 67646-9764 | |
| (785) 689-4220 | |
| (785) 689-4219 |
| Full Name | Logan Medical Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 214 W Main St, Logan, Kansas |
| Authorized Official Name and Position | Rhonda L Kellerman (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 7855435211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Medical Clinic 214 W Main St P.o. Box 173 Logan KS 67646-9764 Ph: (785) 689-4220 | Logan Medical Clinic 214 W Main St Logan KS 67646-9764 Ph: (785) 689-4220 |
| NPI Number | 1619913613 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 04/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619913613 | NPI | - | NPPES |
| 100409050C | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0433764 (Kansas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 363L00000X | Nurse Practitioner | 44437 (Kansas) | Secondary |
Logan Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 W Main St, Logan, KS 67646 Phone: 785-877-3351 Fax: 785-877-2841 |