MEDICARE: CARL DARNALL 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	0102204108	VA

General Provider Information

NPI Number	:	1689121006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARL DARNALL ARMY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	CARL DARNALL ARMY MEDICAL CENTER
Second Line	:	36065 SANTE FE AVE FORT HOOD, TEXAS
City	:	APO
State	:	AA
Zip	:	76544-9997
Country	:	US
Telephone Number	:	254-553-5319
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARL DARNALL ARMY MEDICAL CENTER
Second Line	:	36065 SANTE FE AVE
City	:	APO
State	:	AA
Zip	:	76544-9997
Country	:	US
Telephone Number	:	254-553-5319
Fax Number	:

Authorized Official
Title or Position	:	INTERNAL MEDICINE STAFF PHYSICIAN
Name	:	DORIAN ANDERSON
Credential	:	D.O
Telephone Number	:	936-443-4804

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	09/01/2016

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