Organization
WILFORD HALL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DARLON JACKSON GS-09 (SUPERVISOR CREDENTIALS MANAGER)
(210) 292-6707
Entity
Organization
Contact information
Practice address
2200 BERGQUIST DR, ATTN: CREDENTIALS (CMC), LACKLAND AFB,, TX 78236-5300
(210) 292-6707
(210) 292-7964
Mailing address
2200 BERGQUIST DR, ATTN: CREDENTIALS (CMC), LACKLAND AFB,, TX 78236-5300
(210) 292-6707
(210) 292-7964
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
S14188
TX
Other
Enumeration date
01/06/2006
Last updated
08/22/2020
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