SOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC - NPI 1992100622

Q: What is South Logan Medical Management Svcs LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

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About South Logan Medical Management Svcs Llc NPPES

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

SOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC (NPI 1992100622), doing business as South Logan Family Practice, is a healthcare organization registered as a health service in Denver, Colorado and active in the NPI registry since October 2014. The organization lists Georgette V Laws-willis, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1992100622

Entity TypeOrganization

Primary Taxonomy261QH0100X

Legal Business NameSOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC

Location Address895 S LOGAN STDenver, CO 80209-4127

Mailing Address895 S Logan StDenver, CO 80209-4127 · (303) 733-3764 · Fax (303) 733-3764

Phone(303) 733-3764

Fax(303) 733-3764

Organization SubpartNo

Authorized OfficialGeorgette V Laws-willisOffice Manager · (303) 733-3764

Enumeration DateOctober 23, 2014

✔ NPI 1992100622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities

Taxonomy Code261QH0100X

895 S LOGAN ST, Denver, CO 80209

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Other Names 1

Former Legal Business NameSouth Logan Family Practice

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.

MRS. DWIGHT DUNCAN PSYD

Psychologist (Clinical)