42d Medical Group

NPI 1033196878 - Clinic/Center - 261QM1101X

NPI Details
NPI 1033196878
Enumeration Date 12/22/2005
Last Updated 03/03/2014
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name THERESA MARIE THERESA
Position AIR FORCE UBO ANALYST
Phone (334) 953-4943
Fax (334) 953-1741
Practice Location
300 SOUTH TWINING ST
BUILDING 760
MAXWELL AFB AL, 36112-6219, US
Phone (334) 953-4943
Fax (334) 953-1741
Business Location
300 SOUTH TWINING ST
BUILDING 760
MAXWELL AFB AL, 36112-6219, US
Phone (334) 953-4943
Fax (334) 953-1741
Toxanomy
Taxonomy Code 261QM1101X
License State
License Number
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According to our database, 42d Medical Group NPI is 1033196878, taxonomy code is 261QM1101X 42d Medical Group physically located at 300 South Twining St, Maxwell Afb AL, 36112-6219. NPI Number 1033115704 has the healthcare provider type.

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1033196878 NPI number is provided on an as is basis without warranty of any kind. 1033196878 is maintained by the National Plan & Provider Enumeration System. The contents of 42d Medical Group are for informational purposes only.