1104805142 17TH MEDICAL GROUP
Military/U.S. Coast Guard Outpatient Clinic/Center
Active
Basic Information
- Organization Name
- 17TH MEDICAL GROUP
- Enumeration Date
- January 10, 2006
- Last Update
- November 15, 2010
- Authorized Official
- SERENA LYNN HANSKEN
AIR FORCE UNIFORM BUSINESS OFFICE
Phone: (703) 588-6419
Practice Location
- Address
- 271 FORT RICHARDSON AVE
GOODFELLOW AFB, TX 769084901 - Phone
- (325) 654-5974
- Fax
- (325) 654-3121
Mailing Address
- Address
- 271 FORT RICHARDSON AVE
GOODFELLOW AFB, TX 769084901 - Phone
- (325) 654-5974
- Fax
- (325) 654-3121
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center Military and U.S. Coast Guard Ambulatory Procedure | 261QM1101X | Clinic/Center | N/A | N/A | No |
| Military/U.S. Coast Guard Pharmacy | 332000000X | Military/U.S. Coast Guard Pharmacy | N/A | N/A | No |
| Military/U.S. Coast Guard Outpatient Clinic/Center Military/U.S. Coast Guard Outpatient | 261QM1100X | Clinic/Center | N/A | TX | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4596740 | 01 | TX | NCPDP |
Frequently Asked Questions
What is 17TH MEDICAL GROUP's NPI number?
17TH MEDICAL GROUP's NPI number is 1104805142.
Which doctor has NPI number 1104805142?
The doctor with NPI number 1104805142 is 17TH MEDICAL GROUP.
What is 17TH MEDICAL GROUP's practice address?
17TH MEDICAL GROUP's practice address is 271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX, 769084901.
Which doctor practices at 271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX, 769084901?
17TH MEDICAL GROUP practices at 271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX, 769084901.
What is 17TH MEDICAL GROUP's phone number?
17TH MEDICAL GROUP's phone number is (325) 654-5974.
Who is (325) 654-5974?
(325) 654-5974 is the phone number for 17TH MEDICAL GROUP.
What is 17TH MEDICAL GROUP's specialty?
17TH MEDICAL GROUP's specialty is Military/U.S. Coast Guard Outpatient Clinic/Center.
What type of doctor is 17TH MEDICAL GROUP?
17TH MEDICAL GROUP is a Military/U.S. Coast Guard Outpatient Clinic/Center.
Is 17TH MEDICAL GROUP a Military/U.S. Coast Guard Outpatient?
Yes, 17TH MEDICAL GROUP is a Military/U.S. Coast Guard Outpatient.
Is 17TH MEDICAL GROUP still practicing?
Yes, 17TH MEDICAL GROUP is currently practicing.
Is 17TH MEDICAL GROUP accepting new patients?
17TH MEDICAL GROUP may be accepting new patients. Please call their office at (325) 654-5974 to inquire about availability.
Is NPI 1104805142 still active?
Yes, NPI 1104805142 is currently active.
Where does 17TH MEDICAL GROUP practice?
17TH MEDICAL GROUP practices in GOODFELLOW AFB, TX.