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General NPI Number Information
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NPI Number | 1821871450
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Entity Type | Individual
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Provider Name | LOGAN ALLEN FROST PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 945 CHAMBERS ST STE 3
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-4583
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Country | US
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Telephone | 801-627-2122
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Fax | 801-627-2125
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Provider Business Mailing Address
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Address Line | 945 CHAMBERS ST STE 3
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City | OGDEN
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State | UT
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Zip | 84403-4583
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Country | US
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Telephone | 801-627-2122
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Fax | 801-627-2125
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14242594-1206
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License Number State | UT
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