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Contact Information

LOGAN W COFFEE
HIGHWAY 83 SOUTH AND I-40 JUNCTION
VIAN, OK74962
 Phone: 918-773-6200
 Fax: 918-773-6201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LOGAN W COFFEE · (Male)

NPI # 1164465399
Status Active
Credentials
Entity Individual
Enumeration date 06/14/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK License # 5317
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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