MR. MARSHALL LOGAN JR. (NPI# 1699231019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699231019 |
| Entity Type | Individual |
| Full Name | MR. MARSHALL LOGAN JR. |
| Credential | NP-C |
| Practice Address |
6600 Van Aalst Blvd Fort Benning GA 31905-2102 |
| Mailing Address |
6971 Buckhorn Dr Columbus GA 31904-3214 |
| Practice Telephone | 7065446172 |
| Mailing Telephone | 9315727770 |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
214743 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6600 VAN AALST BLVD |
| City | FORT BENNING |
| State | GA |
| Zip Code | 31905-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184608218 | Fletcher Maurice Boulware Jr. | Anesthesiology | 6600 Van Aalst Blvd, Anesthesia Suite 2nd Floor, Fort Benning, GA 31905 | 2005-12-01 |
| 1700486669 | Krystal Smith Dabon | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-29 |
| 1508466731 | Nichelle Pascoe | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-27 |
| 1598372518 | Delli Dorne | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-24 |
| 1205442944 | Vincent Krause | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-18 |
| 1578175824 | Shawn Nguyen | Optometrist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-08-18 |
| 1720606791 | Aylin Seyalioglu | Physical Therapist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-07-07 |
| 1578187431 | Travis Ian Hallquist | Registered Nurse | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-06-05 |
| 1770121899 | Rachel Elizabeth Cobb | Audiologist-Hearing Aid Fitter | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-12-19 |
| 1518516657 | Emily L Derosa | Physician Assistant | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
| 1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
| 1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
| 1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
| 1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
| 1356897953 | Katelyn Dolezal | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-09-01 |
| 1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
| 1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
| 1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
| 1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
| Find all providers in zip 31905 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306910989 | Barbara Ann Reilly | Nurse Practitioner | Marne Road, Fort Benning, GA 31905 | 2006-11-17 |
| 1356448641 | Jacqueline Schuler | Nurse Practitioner | 7956 Martin Loop, Fort Benning, GA 31905-5273 | 2006-09-20 |
| 1700486669 | Krystal Smith Dabon | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-29 |
| 1598372518 | Delli Dorne | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-24 |
| 1205442944 | Vincent Krause | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-18 |
| 1114419785 | Christopher Nathan Garner | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2018-05-30 |
| 1770022352 | Nikola Vujas | Nurse Practitioner | 6600 Van Aalst Blvd., Martin Army Community Hospital, Fort Benning, GA 31905 | 2017-02-16 |
| 1245777291 | Kenneth Earl Davis Jr. | Nurse Practitioner | 6600 Van Aalst Blvd, Bldg 9250, Martin Army Community Hospital, Fort Benning, GA 31905-6535 | 2017-01-30 |
| 1659655629 | Heather Nicole Bolden | Nurse Practitioner | 6600 Van Aalst Blvd, Family Medical Home Martin Army Community Hospital, Fort Benning, GA 31905 | 2011-10-07 |
| 1033397559 | Natalie Neal Vonhilsheimer | Nurse Practitioner | 7950 Martin Loop, Martin Army Hospital, Fort Benning, GA 31905-6100 | 2008-02-06 |
| Find all providers in FORT BENNING | ||||
| City | FORT BENNING |
| Zip Code | 31905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.