Provider Demographics
NPI:1861476640
Name:LOGUE, HARRY EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:EDWARD
Last Name:LOGUE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:100 CENTURY PARK SOUTH
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3922
Mailing Address - Country:US
Mailing Address - Phone:205-978-7800
Mailing Address - Fax:205-978-7802
Practice Address - Street 1:100 CENTURY PARK SOUTH
Practice Address - Street 2:SUITE 206
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-3922
Practice Address - Country:US
Practice Address - Phone:205-978-7800
Practice Address - Fax:205-978-7802
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL58612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C75842Medicare UPIN