Organization
375TH MEDGRP-SCOTT
Active
Parent organization
375TH MEDGRP-SCOTT
Organization subpart
Yes
Provider details
NPI number
Legal business name
375TH MEDGRP-SCOTT
Authorized official
DR. BRUCE JAY GARDNER II M.D. (RESIDENT PHYSICIAN)
(618) 256-6267
Entity
Organization
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6267
(618) 256-7931
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6267
(618) 256-7931
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
12/15/2005
Last updated
05/29/2025
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