OrganizationActive
Logan Family Practice, LLC
NPI 1902044597 · Primary Care Clinic/Center · Logan, NM
Provider details
- NPI number
- 1902044597
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lajuana Willis, Member(575) 487-9000
- License
- R14626 (NM)
Specialties & taxonomies
Ambulatory Health Care Facilities
Physician Assistants & Advanced Practice Nursing Providers
Practice location
600 Gallegos
Logan, NM 88426-7602
Phone: (575) 487-9000
Fax: (575) 487-9002
Approximate (ZIP-level) locationGet directions
Mailing address
600 Gallegos
Logan, NM 88426-7602
Registry dates
- Enumerated
- 2009-02-04
- Last updated
- 2014-02-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.