LOGAN WIGGINS BOLDWILL (NPI# 1912352675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912352675 |
| Entity Type | Individual |
| Full Name | LOGAN WIGGINS BOLDWILL |
| Credential | M.D. |
| Practice Address |
2000 S Palestine St Athens TX 75751-5610 |
| Mailing Address |
510b Karey Dr Temple TX 76502-8727 |
| Practice Telephone | 9036761000 |
| Practice Fax Number | 9036761337 |
| Mailing Telephone | 9035396544 |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2019-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R9574 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
2000 S PALESTINE ST |
| City | ATHENS |
| State | TX |
| Zip Code | 75751-5610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730177601 | Athens Anesthesia Services, Pa | Nurse Anesthetist, Certified Registered | 2000 S Palestine St, Athens, TX 75751-5610 | 2005-10-13 |
| 1104382597 | Amy Jo Shuptrine | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2019-02-11 |
| 1417465824 | Athens Hospital, LLC | General Acute Care Hospital | 2000 S Palestine St, Athens, TX 75751-5610 | 2018-01-19 |
| 1336447234 | Crystal D Pham | Nurse Anesthetist, Certified Registered | 2000 S Palestine St, Athens, TX 75751-5610 | 2011-03-02 |
| 1841352424 | James Lowell Ryman | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-12-13 |
| 1770685356 | Molly Johnston | Nurse Anesthetist, Certified Registered | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-09-02 |
| 1083721401 | Carl Caroe | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-08-23 |
| 1487672861 | Christopher W Bristow | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-07-17 |
| 1851319289 | Regina G Goodwyn | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-07-17 |
| 1821016189 | Daniel Wilson Bywaters | Emergency Medicine | 2000 S Palestine St, Athens, TX 75751-5610 | 2006-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700414810 | Morghan Jungman | Physical Therapy Assistant | 6444 South Palestine St, Athens, TX 75751 | 2020-04-01 |
| 1497313340 | Rebecca Lynne Moehlenbrock | Physical Therapy Assistant | 711 Lucas Dr., Athens, TX 75751 | 2019-06-04 |
| 1013487669 | Jammie Jae Chaney | Licensed Vocational Nurse | 207 Colonial Circle, Athens, TX 75751 | 2018-11-27 |
| 1215423397 | Valarie M Chambless | Registered Nurse | 1505 Hwy. 19 South, Athens, TX 75751 | 2018-07-02 |
| 1609378181 | Jennifer Lynn Griffith | Occupational Therapist | 907 S Palenstine St., Athens, TX 75751 | 2018-03-01 |
| 1285931832 | Leonard J Barbarisi | Surgery | 6444 S Palestine, Athens, TX 75751 | 2011-02-17 |
| 1801123104 | Paul J Michiels | Family Medicine | 5313 Fm 2494, Athens, TX 75751 | 2009-11-06 |
| 1851527550 | Jordan Risinger | Dentist | 800 S. Palestine St., Athens, TX 75751 | 2009-06-08 |
| 1306005798 | Shawn Tai | Internal Medicine | 115 Medical Cir Ste 106, Athens, TX 75751 | 2008-06-02 |
| 1083730683 | Assisted Living Concepts Inc | Assisted Living Facility | 213 Cayuga Drive, Athens, TX 75751 | 2007-03-22 |
| Find all providers in zip 75751 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346897550 | Leap Medical Services LLC | Internal Medicine | 22375 Troon Dr, Athens, AL 35613-8138 | 2019-08-22 |
| 1083140230 | Leah Anne Reid | Internal Medicine | 1270 Prince Ave., Suite 201, Athens, GA 30606 | 2017-05-10 |
| 1548795701 | Rebekah Danielle Sherlin-chaplin | Internal Medicine | 325 County Road 126, Athens, TN 37303-6770 | 2017-04-25 |
| 1972850055 | Junaid Nasir | Internal Medicine | 5105 Jefferson Rd Ste B, Athens, GA 30607 | 2012-08-08 |
| 1942594973 | Andrew C. Mckown | Internal Medicine | 3320 Old Jefferson Rd Ste 200a, Athens, GA 30607-1478 | 2011-06-07 |
| 1326285537 | W Randolph Purdy | Internal Medicine | 65 Pine Ln, Athens, OH 45701-3426 | 2009-01-09 |
| 1730338815 | Anna Alexander | Internal Medicine | 2142 West Broad Street, Building 200, Kaiser Permanente Athens Medical Center, Athens, GA 30606 | 2008-09-15 |
| 1952567505 | Kuang Shah Chang | Internal Medicine | 3320 Old Jefferson Rd Ste 700, Athens, GA 30607-1465 | 2008-08-04 |
| 1043483720 | James L. Brown, Jr., M.d., P.C. | Internal Medicine | 2090 Prince Ave, Building A, Athens, GA 30606-6047 | 2008-04-02 |
| 1346428356 | Clara Herrin | Internal Medicine | 370 River Rd, Athens, GA 30602-1526 | 2008-02-01 |
| Find all providers in ATHENS | ||||
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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.