Provider Demographics
NPI:1346224003
Name:LOGGINS, JAMIE PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:PAUL
Last Name:LOGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIGH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7653
Mailing Address - Country:US
Mailing Address - Phone:207-795-5710
Mailing Address - Fax:207-795-2559
Practice Address - Street 1:10 HIGH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7653
Practice Address - Country:US
Practice Address - Phone:207-795-5710
Practice Address - Fax:207-795-2559
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017220208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME4331194499Medicaid
MEME2026Medicare PIN