Jerry W Logan, OD

NPI #1043370125 in Richmond, Indiana

Provider Information

NPI Number: 1043370125
Entity Type: Individual
Name: Jerry W Logan, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Dec 11, 2006
Last Updated: Apr 10, 2008

Practice Location

Address: 2519 E MAIN ST
City: Richmond
State: Indiana
ZIP Code: 47374-5867
Phone: (765) 966-2661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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