Provider Demographics
NPI:1457921082
Name:FORD, LOGAN SPENSER (MD)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:SPENSER
Last Name:FORD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:985575 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-5575
Mailing Address - Country:US
Mailing Address - Phone:402-552-6074
Mailing Address - Fax:405-552-6773
Practice Address - Street 1:985575 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-5575
Practice Address - Country:US
Practice Address - Phone:402-552-6074
Practice Address - Fax:405-552-6773
Is Sole Proprietor?:No
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
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Provider Licenses
StateLicense IDTaxonomies
NE91282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry