Provider Demographics
NPI:1134962905
Name:FELTON, LOGAN (DO)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:HUNKER
Mailing Address - State:PA
Mailing Address - Zip Code:15639-1042
Mailing Address - Country:US
Mailing Address - Phone:814-599-9079
Mailing Address - Fax:
Practice Address - Street 1:ONE EXCELA HEALTH DRIVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-537-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT023827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine