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General NPI Number Information
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NPI Number | 1043426893
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Entity Type | Organization
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Legal Business Name | ACH BRIAN D ALLGOOD-PYEONGTAEK
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | UNIT 15543
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City | APO
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State | AP
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Zip | 96224
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Country | US
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Telephone | 01182279171410
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Fax |
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Provider Business Mailing Address
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Address Line | UNIT 15244 BOX 316 ATTN UBO
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City | APO
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State | AP
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Zip | 96205-5244
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Country | US
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Telephone | 01182279171858
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Fax |
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Authorized Official
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Title or Position | DHA
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Name | WILLIAM MICHAEL CONDON
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Credential |
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Telephone | 240-401-3643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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License Number State |
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