Provider Demographics
NPI:1023197738
Name:LOGAN, JENNIFER JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JOYCE
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1752 CROSS KEYS RD
Mailing Address - Street 2:
Mailing Address - City:SHORTER
Mailing Address - State:AL
Mailing Address - Zip Code:36075-3748
Mailing Address - Country:US
Mailing Address - Phone:251-490-8922
Mailing Address - Fax:251-415-1457
Practice Address - Street 1:287 MITYLENE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3547
Practice Address - Country:US
Practice Address - Phone:334-290-4200
Practice Address - Fax:334-290-4190
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-02-28
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Provider Licenses
StateLicense IDTaxonomies
AL28640207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology