Healthcare Provider Details

I. General information

NPI: 1053036855
Provider Name (Legal Business Name): LOGAN BOBBITT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CRAMER CREEK CT
DUBLIN OH
43017-2586
US

IV. Provider business mailing address

299 CRAMER CREEK CT
DUBLIN OH
43017-2586
US

V. Phone/Fax

Practice location:
  • Phone: 614-889-5722
  • Fax: 614-889-9335
Mailing address:
  • Phone: 614-889-5722
  • Fax: 614-899-9335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2202576-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: