MEDICARE: LOGAN DAVIDSON GOODMAN COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA003034	GA

General Provider Information

NPI Number	:	1568295426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOGAN DAVIDSON GOODMAN COTA

Provider Business Mailing Address
First Line	:	541 HULSEY DR
Second Line	:
City	:	METTER
State	:	GA
Zip	:	30439-3609
Country	:	US
Telephone Number	:	912-243-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 MATHIS AVE
Second Line	:
City	:	TWIN CITY
State	:	GA
Zip	:	30471-4232
Country	:	US
Telephone Number	:	478-763-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2024
Last Update Date	:	08/24/2024

Similar Medicare Providers

1588836738 — TWIN VIEW OPERATOR LLC
Practice Location Address:

211 MATHIS AVE - BOX 1460
TWIN CITY, GA
30471-4232

Practice Phone: 478-763-2141
Practice Fax: 478-763-3759

1396606323 — TWIN CITY TRAILS OF JOURNEY LLC
Practice Location Address:

211 MATHIS AVE
TWIN CITY, GA
30471-4232

Practice Phone: 478-763-2141
Practice Fax:

1134119936 — EMANUEL COUNTY HOSPITAL AUTHORITY
Practice Location Address:

511 GILLIKEN ST
TWIN CITY, GA
30471

Practice Phone: 478-763-3036
Practice Fax: 478-763-3787

1265526057 — 2-K PHARMAKON SERVICES LLC
Practice Location Address:

507 S RAILROAD AVE
TWIN CITY, GA
30471-4355

Practice Phone: 478-763-2151
Practice Fax: 478-763-3833

1598828691 — NATIONAL ASSISTANCE BUREAU INC.
Practice Location Address:

211 MATHIS AVE
TWIN CITY, GA
30471

Practice Phone: 478-763-2141
Practice Fax: 478-763-3759

1932416674 — EMANUEL COUNTY BOARD OF HEALTH
Practice Location Address:

503 S RAILROAD AVE
TWIN CITY, GA
30471

Practice Phone: 478-763-3452
Practice Fax:

Directions to “ LOGAN DAVIDSON GOODMAN COTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.