Logan Balkcom

Anesthesiologist Assistant · Tifton, GA

Individual Active NPI

NPI number 1891457768

Practice location

901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120

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NPI record

NPI
1891457768
Entity type
Individual (Type 1)
Enumeration date
October 8, 2021
Last updated
October 8, 2021
Certified
September 8, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Anesthesiologist Assistant Primary 367H00000X 10709 GA

About Logan Balkcom

Logan Balkcom is a healthcare provider registered in the NPI registry with the primary taxonomy Anesthesiologist Assistant (code 367H00000X). The practice location is 901 18TH St E, Tifton, GA 31794-3648. The NPI number 1891457768 was assigned on October 8, 2021 and the record was last updated on October 8, 2021.

Logan Balkcom lists a license in the registry: #10709 (GA) for Anesthesiologist Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Logan Balkcom?

The NPI number is 1891457768.

What is the phone number of Logan Balkcom?

The phone number listed for the practice location is (229) 382-7120.

Where is Logan Balkcom located?

901 18TH St E, Tifton, GA 31794-3648.

What is the taxonomy code for Logan Balkcom?

The primary taxonomy code is 367H00000X – Anesthesiologist Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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