Theodore E Logan Jr.

DMD | Oral and Maxillofacial Surgeon



  
  3101 Breckenridge Ln, Ste 2d, Louisville
  Kentucky, 40220-2742

  502-459-8012    502-459-8021 Maps & Directions
Theodore E Logan Jr. is a Louisville, Kentucky based Oral and Maxillofacial Surgeon who is specialized in Oral and Maxillofacial Surgery. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Theodore E Logan Jr. is 4056 for Oral and Maxillofacial Surgery in Kentucky. His current practice location is 3101 Breckenridge Ln, Ste 2d, Louisville. Patients can reach him at 502-459-8012.
Theodore E Logan Jr. deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Theodore E Logan Jr. speciality, credentials, practice address, contact phone number and fax are as below. Patients can directly walk in or can call on the below given phone number for appointment.
Name: Theodore E Logan Jr.
Specialization: Oral and Maxillofacial Surgeon
Gender:Male
Credentials: DMD
Accepts Medicare Assignment:No
Practice Address:3101 Breckenridge Ln, Ste 2d, Louisville,
Kentucky, 40220-2742
Phone:502-459-8012
Fax:502-459-8021
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number: 1245231778
NPI Enumeration Date: 09 Aug, 2005
NPI Last Update On: 08 Jul, 2007

Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Theodore E Logan Jr. are as mentioned below.
License NumberSpecializationStateStatus
4056Oral and Maxillofacial Surgery KentuckyPrimary
Other Medical Identifiers:
Other legacy medical identifiers associated with Theodore E Logan Jr. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
64040561MedicaidKentucky
1055007OtherKentuckyPASSPORT
60040565OtherKentuckyMEDICAID DENTAL
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: 3101 Breckenridge Ln, Ste 2d
Louisville, Kentucky
Zip: 40220-2742
Phone Number: 502-459-8012
Fax Number: 502-459-8021
Patients can reach Theodore E Logan Jr. at 3101 Breckenridge Ln, Ste 2d, Louisville, Kentucky or can call to book an appointment on 502-459-8012. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.

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