| South Logan Family Practice Center | |
|
895 S Logan St Denver CO 80209-4197 | |
| (303) 733-3764 | |
| (303) 733-0868 |
| Full Name | South Logan Family Practice Center |
|---|---|
| Speciality | Family Medicine |
| Location | 895 S Logan St, Denver, Colorado |
| Authorized Official Name and Position | Vicki Laws (OFFICE MANAGER) |
| Authorized Official Contact | 3037333764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Logan Family Practice Center 895 S Logan St Denver CO 80209-4197 Ph: (303) 733-3764 | South Logan Family Practice Center 895 S Logan St Denver CO 80209-4197 Ph: (303) 733-3764 |
| NPI Number | 1053519868 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 05/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053519868 | NPI | - | NPPES |
| 01262021 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26202 (Colorado) | Primary |
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