# DDEAMC

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

## Provider details

- **NPI number:** 1740446905
- **Authorized official:** MRS. CAROLYN L. JONES (LPN)
- **Authorized official phone:** (706) 787-9253

## Contact information

- **Practice address:** 300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
- **Practice address phone:** (706) 787-9253
- **Practice address fax:** (706) 787-9356
- **Mailing address:** 300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
- **Mailing address phone:** (706) 787-9253
- **Mailing address fax:** (706) 787-9356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | LPN024837 | GA | Yes |

## Other

- **Enumeration date:** 08/06/2008
- **Last updated:** 08/06/2008