Provider Demographics
NPI:1407171952
Name:HARDING, LOGAN Z (MD)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:Z
Last Name:HARDING
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 1:77 CALLE PORTAL
Mailing Address - Street 2:SUITE B260A
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2967
Mailing Address - Country:US
Mailing Address - Phone:520-515-9751
Mailing Address - Fax:520-515-9786
Practice Address - Street 1:77 CALLE PORTAL
Practice Address - Street 2:SUITE B-260A
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2967
Practice Address - Country:US
Practice Address - Phone:520-515-9751
Practice Address - Fax:520-515-9786
Is Sole Proprietor?:No
Enumeration Date:2010-03-27
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ43638207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology