Organization
WILFORD HALL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARLON B JACKSON (CREDENTIALS MANAGER)
(210) 292-6707
Entity
Organization
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1 ATTN: CREDENTIALS CMC, LACKLAND A F B, TX 78236-9907
(210) 292-6707
(210) 292-7964
Mailing address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-6408
(210) 292-7660
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
MD057195L
PA
Other
Enumeration date
03/31/2006
Last updated
08/22/2020
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