# USAF

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilford Hall Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861470957
- **Authorized official:** DR. RANDALL JUDSON MCDANIEL DMD (DIRECTOR OF OROFACIAL PAIN)
- **Authorized official phone:** (210) 292-6393

## Contact information

- **Practice address:** 2200 BERQUIST DRIVE, SUITE 1, LACKLAND AFB, TX 78236-5300
- **Practice address phone:** (210) 292-6393
- **Practice address fax:** (210) 292-3338
- **Mailing address:** 2200 BERQUIST DRIVE, SUITE 1, LACKLAND AFB, TX 78236-5300
- **Mailing address phone:** (210) 292-6393
- **Mailing address fax:** (210) 292-3338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 5934-015 | WI | Yes |

## Other

- **Enumeration date:** 01/09/2006
- **Last updated:** 08/22/2020