Provider Demographics
NPI:1598894198
Name:LOGUE, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:LOGUE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5000 W TILGHMAN ST
Mailing Address - Street 2:240
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9109
Mailing Address - Country:US
Mailing Address - Phone:610-395-4044
Mailing Address - Fax:570-476-6213
Practice Address - Street 1:5000 W TILGHMAN ST
Practice Address - Street 2:240
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9109
Practice Address - Country:US
Practice Address - Phone:610-395-4044
Practice Address - Fax:610-395-4044
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-12-19
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Provider Licenses
StateLicense IDTaxonomies
PAMD039996L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA141412Medicare ID - Type UnspecifiedMC