Logan Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39621 Issued in KY

Legal business name

LOGAN PEDIATRICS, PLLC

Practice address

975 Hopkinsville Rd
Russellville, KY 42276-9774

Phone

(270) 726-1266

Fax

(270) 726-1961

NPI assigned

Aug 31, 2006

Organization subpart

No

Name

Varsha Humble, MD

Title

Owner

Phone

(270) 726-1266

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497867089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422769774",
            "telephone_number": "270-726-1266",
            "fax_number": "270-726-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 HOPKINSVILLE RD",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422769774",
            "telephone_number": "270-726-1266",
            "fax_number": "270-726-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUMBLE",
        "authorized_official_first_name": "VARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-726-1266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Memorial Hospital LLC
• Logan Memorial Hospital LLC
• Logan Memorial Hospital LLC
• Logan Orthopaedics
• Logan Orthopaedics
• Logan Physician Practice LLC
• Logan Physician Practice LLC
• Martha E Loomis, MFTA
• Lymphedema Therapy of Southern Ky LLC
• Laura Madison

• All providers in Russellville, KY
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.