LOGAN MEMORIAL HOSPITAL – NPI #1245263631
Obstetrics & Gynecology

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

LOGAN MEMORIAL HOSPITAL is a provider located in RUSSELLVILLE, KY. NPPES has assigned the NPI number 1245263631 to LOGAN MEMORIAL HOSPITAL on July 08, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207V00000X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology.

The NPI profile was last updated on Jun 24, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LOGAN MEMORIAL HOSPITAL below.

NPI Profile for
LOGAN MEMORIAL HOSPITAL

NPI Number
1245263631
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LOGAN MEMORIAL HOSPITAL
Primary location
1623 NASHVILLE ST
SUITE 105
RUSSELLVILLE, KY 42276-8889
Phone: (615) 372-8500 Fax:
Mailing address
680 S 4TH ST # KH-3
LOUISVILLE, KY 40202-2407
Phone: (502) 596-6063 Fax:
Organization Subpart
No
Authorized Official
JOHNETTA TRAYLOR
AO
Phone: (502) 596-6063
Updated
Certification Date
Jun 24, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207V00000X
- Obstetrics & Gynecology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.