Logan Physician Practice LLC

NPI #1013408053 in Russellville, Kentucky

Provider Information

NPI Number: 1013408053
Entity Type: Organization
Organization Name: Logan Physician Practice LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 25, 2018
Last Updated: Apr 13, 2023

Practice Location

Address: 975 HOPKINSVILLE RD
City: Russellville
State: Kentucky
ZIP Code: 42276-9774
Phone: (270) 726-2738

Authorized Official

Name: KATHY TEAGUE
Title: VP, CORPORATE SECRETARY
Phone: (629) 253-5121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Pediatrics	208000000X
Clinic/Center - Rural Health — Rural Health	261QR1300X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Internal Medicine	207R00000X	Primary

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