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Organization

DEPARTMENT OF DEFENSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HECTOR LUIS LUNA PA-C (CAPTAIN/PHYSICIAN'S ASSISTANT)
(706) 787-1102
Entity
Organization

Contact information

Practice address
41ST STREET, BLDG 40709 ROOM 207 DDEAMC; MEB, PAD, FORT GORDON, GA 30905
(706) 787-1102
Mailing address
41ST STREET, BLDG 40709 ROOM 207 DDEAMC; MEB, PAD, FORT GORDON, GA 30905
(706) 787-1102

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-02514
NC

Other

Enumeration date
11/19/2011
Last updated
11/19/2011
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