# WILFORD HALL MEDICAL CENTER

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

## Provider details

- **NPI number:** 1912968595
- **Authorized official:** MRS. DARLON B JACKSON (CREDENTIALS MANAGER)
- **Authorized official phone:** (210) 292-6707

## Contact information

- **Practice address:** 2200 BERGQUIST DR, SUITE 1 ATTN: CREDENTIALS CMC, LACKLAND A F B, TX 78236-9907
- **Practice address phone:** (210) 292-6707
- **Practice address fax:** (210) 292-7964
- **Mailing address:** 2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
- **Mailing address phone:** (210) 292-6408
- **Mailing address fax:** (210) 292-7660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | MD057195L | PA | Yes |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 08/22/2020