Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LARS OPTIMUS LOGDBERG, M.D.
ActiveLARS OPTIMUS LOGDBERG, M.D. is a Emergency Medical Services healthcare provider located in AVON, Indiana. NPI 1417376369 is currently active in the NPPES registry. Verify at CMS.
Emergency Medical Services · AVON, IN
Registration Details
- NPI Number
- 1417376369
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 8, 2014 (12.373804439547 yrs)
- Last Updated
- Jun 14, 2021
- License
-
01079959A (IN)
Practice Information
- Address
-
1111 RONALD REAGAN PKWYAVON, IN, 461237085Browse IN providers · Browse ZIP 46123
- Phone
- 3172173500
- Fax
- 3172173115
- Primary Specialty
-
Emergency Medical Services
207PE0004X
- Additional Specialty
- Emergency Medical Services
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.