Bret W. Logan, M.D, PLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD34842 Issued in TN

Practice address

Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223-5349

Phone

(270) 798-8372

Fax

(270) 956-0180

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1205804317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8372",
            "fax_number": "270-956-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235349",
            "telephone_number": "270-798-8372",
            "fax_number": "270-956-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "BRET",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D, PLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD34842",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "MD34842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W Lipe, LCSW
• Ryan Lipe
• Marty Robert Litchfield, P.A.
• Amy Cao Liu, MD
• Joshua Ian Lockwood, RDN
• Deborah Anne Logan, CRDH
• Trevor Carnegie Lomax, MS, RD, CSSD, CSCS
• Michael A Lombardo, PA-C
• Tre' Addison Long, LCSW
• Mary Longo, M.S. CCC-SLP

• Child & Adolescent Psychiatry Physician in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Child & Adolescent Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.