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General NPI Number Information
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NPI Number | 1912133786
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Entity Type | Organization
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Legal Business Name | UNITED STATES AIR FORCE
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Dates
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Enumeration Date | 06/06/2009
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Last Update Date | 06/06/2009
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Provider Practice Location Address
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Address Line | 4810 COYOTE RUN
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City | ABILENE
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State | TX
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Zip | 79602-8185
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Country | US
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Telephone | 325-965-5490
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Fax |
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Provider Business Mailing Address
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Address Line | 4810 COYOTE RUN
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City | ABILENE
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State | TX
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Zip | 79602-8185
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Country | US
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Telephone | 325-965-5490
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Fax |
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Authorized Official
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Title or Position | INDEPENDENT DUTY MEDICAL TECHNICIAN
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Name | SARA HAY
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Credential |
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Telephone | 325-965-5490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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