Provider Demographics
NPI:1710921242
Name:LOGGINS, WILLIAM FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FREDERICK
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 1:241 DESHA RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1803
Mailing Address - Country:US
Mailing Address - Phone:859-494-4425
Mailing Address - Fax:
Practice Address - Street 1:466 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1841
Practice Address - Country:US
Practice Address - Phone:859-874-5173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20199207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64201999Medicaid
KY64201999Medicaid
C78403Medicare UPIN