# MARTIN ARMY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDDAC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770664849
- **Authorized official:** MR. JAMES KELLY SMITH JR. PA (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (706) 544-9426

## Contact information

- **Practice address:** TMC \#5, 11TH AIRBORNE DIVISION ROAD, FT. BENNING, GA 31901
- **Practice address phone:** (706) 544-9426
- **Mailing address:** 1629 PRESTON DR, COLUMBUS, GA 31906-1642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2865M2000X | Military General Acute Care Hospital | 01807 | GA | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020