Provider Demographics
NPI:1538666490
Name:PIERCE, LOGAN LITTLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LOGAN
Middle Name:LITTLE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:1050 LENOX PARK BLVD NE APT 9302
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-5850
Mailing Address - Country:US
Mailing Address - Phone:205-936-9757
Mailing Address - Fax:
Practice Address - Street 1:3400 OLD MILTON PKWY STE 190
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3707
Practice Address - Country:US
Practice Address - Phone:770-663-1100
Practice Address - Fax:770-663-1101
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical