Physician Assistant
LOGAN SLACK
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1982328480 · enumerated 2022-09-28 · record updated 2024-05-20. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 1300 ANNE ST NW, BEMIDJI, MN, 56601-5103 (218) 751-9746 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 5074, SIOUX FALLS, SD, 57117-5074 (605) 328-9419 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant 363A00000X
- Physician Assistant 363A00000X · Primary · License 14888 MN
In this directory
Locations and evidence
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Practice location
BEMIDJI, MN, 566015103
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.