Healthcare Provider Details

I. General information

NPI: 1720728413
Provider Name (Legal Business Name): LOGAN JAMES VAN HON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 ELECTRIC RD
SALEM VA
24153-7494
US

IV. Provider business mailing address

2236 MOUNTAIN VIEW TER SW
ROANOKE VA
24015-5544
US

V. Phone/Fax

Practice location:
  • Phone: 540-776-4000
  • Fax:
Mailing address:
  • Phone: 651-895-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number82020
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101282048
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: