Individual ProviderZachary LoganFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address6843 E Main St, Mesa, AZ 85207-8207(480) 870-7300(615) 315-5257PECOS EnrollmentBased on the most recent information from CMS, provider Zachary Logan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 10:58 AM.Profile DetailsProvider ID1538521620Provider TypeIndividualFull NameLogan, ZacharyGenderMaleSole ProprietorNoEnumeration Date3/28/2016Last Updated9/6/2022Contact InformationPractice LocationPractice Address6843 E Main St, Mesa, AZ 85207-8207Phone(480) 870-7300Fax(480) 870-7302Mailing LocationMailing Address102 Woodmont Blvd Ste 600, Nashville, TN 37205-5250Phone(615) 315-5257FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense67357ArizonaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense59949Tennessee