# MAXWELL AFB AMBULATORY HEALTH CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396738944
- **Authorized official:** DR. TOMEKA DANIELLE RUSSELL M.D. (FAMILY PRACTICE PHYSICIAN)
- **Authorized official phone:** (334) 953-1307

## Contact information

- **Practice address:** 300 S. TWINING STREET, BLDG 760, FAMILY PRACTICE - YELLOW TEAM, MAXWELL AFB, AL 36112
- **Practice address phone:** (334) 953-2234
- **Mailing address:** 375 ASHTON PARK DR, MILLBROOK, AL 36054
- **Mailing address phone:** (334) 290-0399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | 25934 | AL | Yes |

## Other

- **Enumeration date:** 08/30/2005
- **Last updated:** 08/22/2020