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Organization
81ST MEDICAL GROUP
Active
Organization
81ST MEDICAL GROUP
Active
Other names
Keesler Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LARAMIE JAY RICHMOND (PHYSICIAN ASSISSTANT)
(228) 376-0440
Entity
Organization
Contact information
Practice address
301 FISHER ST, 81 MDOS SGOF, KEESLER AFB, MS 39534-2508
(228) 376-0440
Mailing address
301 FISHER ST, 81 MDOS SGOF, KEESLER AFB, MS 39534-2508
(228) 376-0440
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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