NPI 1104387794 · live from the CMS NPI Registry
Logan Debord, MD
Dermatology in Frisco, CO. National Provider Identifier 1104387794, active.
NPI record
| NPI | 1104387794 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 984 N 10 Mile Dr, #103, Frisco, CO 80443 |
| Practice phone | 970-668-0998 |
| Mailing address | 7300 Ranch Road 2222, Building 1, Ste 200, Austin, TX 78730 |
| Enumerated | March 27, 2019 |
| Last updated | February 24, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | DR.0069923 (CO) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.