Logan, Timothy W

Logan, Timothy W is an individual health care provider with primary practice located at 9800 Shelbyville Rd Suite 202, Louisville KY 40223-2977. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Logan, Timothy W can be contacted via phone (502) 429-0526.

Contact Information

Primary practice address
9800 Shelbyville Rd Suite 202 Louisville KY 40223-2977
Phone: (502) 429-0526
Fax: (502) 429-0532
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 5015 Kentucky
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12010128A Indiana

Profile Details

NPI number 1548227655
LBN Legal business name Logan, Timothy W
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

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 1548227655 NPPES
Other 000000049874 BLUE CROSS BLUE SHIELD

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