MEDICARE: MRS. CATHERINE ANNE LOGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	251577	MA
2	225100000X	Physical Therapist	17313	MA
3	207X00000X	Orthopaedic Surgery Physician	DR.0058454	CO

General Provider Information

NPI Number	:	1740209592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE ANNE LOGAN MD

Provider Business Mailing Address
First Line	:	4500 E 9TH AVE STE 420
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3931
Country	:	US
Telephone Number	:	720-726-7995
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 E 9TH AVE STE 420
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3931
Country	:	US
Telephone Number	:	720-726-7995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/12/2023

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