Logan, Mark

Logan, Mark is an individual health care provider with primary practice located at 1401 Professional Blvd , Evansville IN 47714-8014. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Logan, Mark can be contacted via phone (812) 473-2060.

Contact Information

Primary practice address
1401 Professional Blvd Evansville IN 47714-8014
Phone: (812) 473-2060
Fax: (812) 473-0763
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 32870 Kentucky
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01046534A Indiana

Profile Details

NPI number 1720077407
LBN Legal business name Logan, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jun 30th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720077407 NPPES
Kentucky Other 000000045660 ANTHEM
Kentucky Other 000000045660 ANTHEM
Kentucky Other 040003023 ANTHEM
Kentucky MEDICAID 200149220A ANTHEM
Kentucky Other P00076697 ANTHEM
Kentucky MEDICAID 64328701 ANTHEM
Kentucky Other 064945 ANTHEM
Kentucky Other 394258 ANTHEM

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