Healthcare Provider Details
I. General information
NPI: 1922443811
Provider Name (Legal Business Name): VETERAN AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2013
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4303 PITMAN & THOMAS
FORT SILL OK
73503
US
IV. Provider business mailing address
4303 PITMAN & THOMAS
FORT SILL OK
73503-1931
US
V. Phone/Fax
- Phone: 405-209-6919
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 286500000X |
| Taxonomy | Military Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTINA
ALMSTROM
WHELAN
Title or Position: PSYCHOLOGIST
Credential:
Phone: 405-209-6919