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General NPI Number Information
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NPI Number | 1699105304
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Entity Type | Individual
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Provider Name | ROBERT JOSHUA LOGAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 613 23RD ST STE 340
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City | ASHLAND
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State | KY
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Zip | 41101-2879
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Country | US
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Telephone | 606-329-2888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-408-6200
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Fax | 606-408-6612
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1630
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2372
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.006077RX
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2096
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License Number State | WV
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TC717
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License Number State | KY
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