MEDICARE: US ARMY- WOMACK ARMY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	286500000X	Military Hospital

General Provider Information

NPI Number	:	1265590756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	US ARMY- WOMACK ARMY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	3549 ROSEBANK DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	WOMACK ARMY MEDICAL CTR
Second Line	:	STOP A, 2817 REILLY ROAD
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	9
Fax Number	:

Authorized Official
Title or Position	:	DEPARTMENT CHIEF
Name	:	DR. RICHARD KYNION
Credential	:
Telephone Number	:	910-907-8458

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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