Provider Demographics
NPI:1881630655
Name:LOGAN, JAMES J (MD)
Entity Type:Individual
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First Name:JAMES
Middle Name:J
Last Name:LOGAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1062 FORSYTH ST
Mailing Address - Street 2:SUITE 2-C
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8637
Mailing Address - Country:US
Mailing Address - Phone:478-755-0036
Mailing Address - Fax:478-755-1254
Practice Address - Street 1:1062 FORSYTH ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8637
Practice Address - Country:US
Practice Address - Phone:478-755-0036
Practice Address - Fax:478-755-1254
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2012-12-20
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Provider Licenses
StateLicense IDTaxonomies
GA0404652080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology