DR. LOGAN WALLACE, MD
Student in an Organized Health Care Education/Training Program
Active
Individual
NPI: 1811567100
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes | - |
Frequently Asked Questions
NPI 1811567100 is the National Provider Identifier for DR. LOGAN WALLACE, MD, a Student in an Organized Health Care Education/Training Program provider located in Johnson City, TN. This NPI was enumerated on June 29, 2021.
DR. LOGAN WALLACE, MD practices at 400 N STATE OF FRANKLIN RD, Johnson City, TN 37604.
Quick Facts
- NPI
- 1811567100
- Type
- Individual
- Enumerated
- Jun 29, 2021
- Last Updated
- Jun 22, 2025
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