Provider Demographics
NPI:1528472495
Name:KOEHLER, LOGAN (MD)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:KOEHLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2200 BRYANT WILLIAMS DR
Mailing Address - Street 2:STE 1
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1121
Mailing Address - Country:US
Mailing Address - Phone:541-274-2700
Mailing Address - Fax:
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:WILLIAM BEAUMONT ARMY MEDICAL CENTER /ORTHOPAEDIC
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-742-2288
Practice Address - Fax:915-742-1931
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2020-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD198429207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery