| Organization Name: | LOGGERHEAD MEDICAL LLC |
| NPI Number: | 1023041001 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY L LAYTON (OWNER) |
| Mailing Address: | 307 E New Haven Ave Melbourne |
| State: | FL US |
| Postal Code: | 329014576 |
| Phone Number: | 3217298223 |
| Fax Number: | 3217296252 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 09/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2081P2900X |
| License Number: | ME105112 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Physical Medicine & Rehabilitation |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |