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Search › North Carolina › 2085R0202X

Logan Jackson, MD

NPI 1740817261 · on the registry since 2020

Practice

Address
3623 Latrobe Dr Ste 216
Charlotte, NC 28211
Phone
(704) 332-1291
Organisation at this address
Stemap Llc
Delacy C Llc
Kerry Taylor Inc
Progressive Care Llc
Atum Professional Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
135

Additional practice sites

  • 1215 Lee St, Charlottesville, VA
  • 251 E Huron St, Chicago, IL

Registry record

Primary taxonomy
2085R0202X
2085R0202X
Also registered as
390200000X
2085R0202X
2085R0202X
Licence states on file
SC, VA, IL, NC
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-11-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina