Provider Demographics
NPI:1184965667
Name:LOGAN, WILLIAM SEARLE (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SEARLE
Last Name:LOGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3176
Mailing Address - Country:US
Mailing Address - Phone:816-842-2500
Mailing Address - Fax:815-842-9980
Practice Address - Street 1:428 W 42ND ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3176
Practice Address - Country:US
Practice Address - Phone:816-842-2500
Practice Address - Fax:815-842-9980
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS207452084F0202X
MOR7B572084F0202X
TXE86702084F0202X
NE183642084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry