509th Medical Group-sgsr

NPI 1033196480 - Clinic/Center - 261QM1101X

NPI Details
NPI 1033196480
Enumeration Date 12/28/2005
Last Updated 02/28/2014
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name THERESA MARIE THERESA
Position AIR FORCE UBO ANALYST
Phone (660) 687-1838
Fax (660) 687-5121
Practice Location
331 SIJAN AVE
509 MDSS SGSR
WHITEMAN AFB MO, 65305-1269, US
Phone (660) 687-1838
Fax (660) 687-5121
Business Location
331 SIJAN AVE
509 MDSS SGSR
WHITEMAN AFB MO, 65305-1269, US
Phone (660) 687-1838
Fax (660) 687-5121
Toxanomy
Taxonomy Code 261QM1101X
License State
License Number
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According to our database, 509th Medical Group-sgsr NPI is 1033196480, taxonomy code is 261QM1101X 509th Medical Group-sgsr physically located at 331 Sijan Ave, Whiteman Afb MO, 65305-1269. NPI Number 1033115704 has the healthcare provider type.

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1033196480 NPI number is provided on an as is basis without warranty of any kind. 1033196480 is maintained by the National Plan & Provider Enumeration System. The contents of 509th Medical Group-sgsr are for informational purposes only.