Healthcare Provider Details

I. General information

NPI: 1609300037
Provider Name (Legal Business Name): LOGAN COLLINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W LEOTA ST
NORTH PLATTE NE
69101-6525
US

IV. Provider business mailing address

1120 W REID AVE
NORTH PLATTE NE
69101-6451
US

V. Phone/Fax

Practice location:
  • Phone: 308-568-8000
  • Fax:
Mailing address:
  • Phone: 308-568-8000
  • Fax: 308-568-8769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2189
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2189
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: