DIETZE & LOGAN SPINE SPECIALIST, LLC (NPI# 1609316322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609316322 |
| Entity Type | Organization |
| Organization Name | DIETZE & LOGAN SPINE SPECIALIST, LLC |
| Practice Address |
29301 N Dixie Ranch Rd Lacombe LA 70445-5403 |
| Practice Telephone | 9858714114 |
| Practice Fax Number | 9858714130 |
| Mailing Telephone | 9858714114 |
| Mailing Fax Number | 9858714130 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |
| Authorized Official Name | JOHN B LOGAN (PARTNER) |
| Authorized Official Telephone | 9858714114 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD020254 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
29301 N DIXIE RANCH RD |
| City | LACOMBE |
| State | LA |
| Zip Code | 70445-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538135868 | John Brisbane Logan | Orthopaedic Surgery | 29301 N Dixie Ranch Rd, Lacombe, LA 70445 | 2006-02-27 |
| 1366973935 | Spine Innovations, LLC | Specialist | 29301 N Dixie Ranch Rd, Lacombe, LA 70445-5403 | 2017-03-24 |
| 1134650708 | Freedom Spine, LLC | Specialist | 29301 N Dixie Ranch Rd, Lacombe, LA 70445-5403 | 2017-03-24 |
| 1295266195 | Intraoperative Neurophysiological Monitoring | Prevention Professional | 29301 N Dixie Ranch Rd, Lacombe, LA 70445-5403 | 2017-03-22 |
| 1235520164 | Amy St. Romain | Physical Therapist | 29301 N Dixie Ranch Rd, Lacombe, LA 70445-5403 | 2015-02-13 |
| 1851571863 | Lisa Ann Gust | Physical Therapist | 29301 N Dixie Ranch Rd, Lacombe, LA 70445-5403 | 2007-11-07 |
| 1609842947 | Susan J Bryant | Physical Medicine & Rehabilitation | 29301 N Dixie Ranch Rd, Lacombe, LA 70445 | 2006-02-27 |
| 1013983378 | Lorenzo Boykin Fisher | Nurse Practitioner | 29301 N Dixie Ranch Rd, Lacombe, LA 70445 | 2006-02-27 |
| 1316913635 | Donald David Dietze Jr. | Neurological Surgery | 29301 N Dixie Ranch Rd, Lacombe, LA 70445 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062265 | B E Counseling Services | Social Worker | 31196 Highway 190, Lacombe, LA 70445 | 2020-08-06 |
| 1033777479 | Northshore Extended Care Hospital, LLC | Long Term Care Hospital | 64030 La 434, Lacombe, LA 70445 | 2019-05-31 |
| 1265910210 | Lacombe Dental LLC | Dentist | 27403 Hwy 190 Su A, Lacombe, LA 70445 | 2018-08-01 |
| 1053826081 | Lisa M Sandifer | Case Manager/Care Coordinator | 27428 Charlotte St, Lacombe, LA 70445 | 2017-12-13 |
| 1710438932 | Amanda R Leonard | Counselor | 61149 Beulah Street, Lacombe, LA 70445 | 2016-10-24 |
| 1598183899 | Bayou Wellness Center Inc | Clinic/Center | 27403 Hwy 190, Suite B, Lacombe, LA 70445 | 2014-04-03 |
| 1104131135 | Anthony B Bondi | Pharmacist | 28079 Us Hwy 190, Lacombe, LA 70445 | 2010-08-14 |
| 1376729962 | Heather Stewart | Speech-Language Pathologist | 24265 Cane Bayou Lane, Lacombe, LA 70445 | 2008-01-14 |
| 1710166368 | Louisiana Heart Hospital Proffesion Fee, LLC | Radiology | 64030 La Hwy 434, Lacombe, LA 70445 | 2007-10-31 |
| 1104953736 | Stella Jan Borges | Pharmacist | 27395a Hwy 190, Lacombe, LA 70445 | 2007-02-28 |
| Find all providers in zip 70445 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538135868 | John Brisbane Logan | Orthopaedic Surgery | 29301 N Dixie Ranch Rd, Lacombe, LA 70445 | 2006-02-27 |
| 1275509549 | The North Institute, Apmc | Orthopaedic Surgery | 29301 N Dixie Ranch Road, Lacombe, LA 70445 | 2006-02-27 |
| 1043634454 | Paradigm Health System | Orthopaedic Surgery | 64301 Highway 434, Lacombe, LA 70445-5411 | 2014-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801394176 | Spine Cin of Baton Rouge LLC | Orthopaedic Surgery | 9655 Perkins Rd Ste C-217, Baton Rouge, LA 70810-1533 | 2018-01-31 |
| 1992203269 | Optimal Health of La, LLC | Orthopaedic Surgery | 9655 Perkins Rd Ste C-219, Baton Rouge, LA 70810-1533 | 2018-01-31 |
| 1982744595 | Mark Mcdonnell | Orthopaedic Surgery | 1103 Kaliste Saloom Rd Ste 310, Lafayette, LA 70508-5784 | 2007-02-06 |
| 1457388035 | Alexis M Waguespack | Orthopaedic Surgery | 1849 Barataria Blvd, Suite C, Marrero, LA 70072-4203 | 2006-06-27 |
| 1982606356 | Michael T Acurio | Orthopaedic Surgery | 2005 Landry Drive, Bossier City, LA 71111 | 2005-08-15 |
| 1962000687 | Fairway Medical Center, LLC | Orthopaedic Surgery | 67252 Industry Ln, Covington, LA 70433-8704 | 2020-10-14 |
| 1669092326 | Caroline Schneider | Orthopaedic Surgery | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-04-23 |
| 1841820396 | Restore Spine and Pain Specialists, LLC | Orthopaedic Surgery | 15814 Professional Plz, Hammond, LA 70403-1453 | 2020-01-23 |
| 1982167755 | Sla Care of La II, LLC | Orthopaedic Surgery | 3436 Magazine St Ste 550, New Orleans, LA 70115-2413 | 2019-04-09 |
| 1518420389 | Sla Care of La IIi, LLC | Orthopaedic Surgery | 3436 Magazine St Ste 550, New Orleans, LA 70115-2413 | 2019-04-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.