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Organization
97TH MEDGRP-ALTUS
Active
Organization
97TH MEDGRP-ALTUS
Active
Parent organization
97TH MEDGRP-ALTUS
Organization subpart
Yes
Provider details
NPI number
Legal business name
97TH MEDGRP-ALTUS
Authorized official
JEN LEWANDOWSKI (DHA UBO)
(703) 817-4030
Entity
Organization
Contact information
Practice address
301 N 1ST ST, BLDG 46, ALTUS AFB, OK 73523-5004
(580) 481-5400
(580) 481-5416
Mailing address
301 N 1ST ST, BLDG 46, ALTUS AFB, OK 73523-5004
(580) 481-5400
(580) 481-5416
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/01/2006
Last updated
06/17/2025
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