Healthcare Provider Details

I. General information

NPI: 1023690245
Provider Name (Legal Business Name): LOGAN MEREDITH CAPLAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 DULUTH HIGHWAY 120 STE 100
DULUTH GA
30097-4142
US

IV. Provider business mailing address

2270 DULUTH HIGHWAY 120 STE 100
DULUTH GA
30097-4142
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-1933
  • Fax: 404-943-8044
Mailing address:
  • Phone: 404-255-1933
  • Fax: 404-943-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number104718
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: