GREEN MOUNTAIN FAMILY MEDICINE - NPI 1003117078 - Internal Medicine in Rutland, VT

Q: What is Mark E Logan MD PC's NPI number?

The NPI number for Mark E Logan MD PC is 1003117078. It was assigned to this organization in the NPPES registry on November 8, 2010. The provider is doing business as Green Mountain Family Medicine.

Q: What is Mark E Logan MD PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

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About Green Mountain Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREEN MOUNTAIN FAMILY MEDICINE (NPI 1003117078) is a healthcare organization registered as an addiction medicine in Rutland, Vermont and active in the NPI registry since November 2010. The organization lists Mark E Logan, Owner, as its authorized official.

NPPES Registry Identity

NPI1003117078

Entity TypeOrganization

Primary Taxonomy207RA0401X

Legal Business NameMARK E LOGAN MD PC

Location Address199 STRATTON RDRutland, VT 05701-4621

Mailing Address199 Stratton RdRutland, VT 05701-4621 · (802) 775-7798 · Fax (802) 775-7762

Phone(802) 775-7798

Fax(802) 775-7762

Organization SubpartNo

Authorized OfficialMark E LoganOwner · (802) 775-7798

Enumeration DateNovember 8, 2010

Last NPPES UpdateJanuary 12, 2015

✔ NPI 1003117078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RA0401X

License✔ Licensed in VT · 042-0006819

Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

199 STRATTON RD, Rutland, VT 05701

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Other Names 1

Doing Business AsGreen Mountain Family Medicine

Other Identifiers 1

Medicaid1018281VT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA LYNN BEECROFT AGPCNP-BC, PMHNP-BC

Nurse Practitioner (Adult Health)