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General NPI Number Information
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NPI Number | 1417806530
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Entity Type | Individual
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Provider Name | LOGAN BRADY WILDMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 4321 CAROTHERS PKWY
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City | FRANKLIN
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State | TN
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Zip | 37067-8542
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Country | US
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Telephone | 615-435-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 765 MCMURRAY DR APT E15
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City | NASHVILLE
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State | TN
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Zip | 37211-7209
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Country | US
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Telephone | 937-631-1188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03445973
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 49319
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License Number State | TN
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