U.S. Air Force

Primary specialty

Military HospitalTaxonomy code 286500000X

License

01060712A Issued in IN

Legal business name

U.S. AIR FORCE

Practice address

WHMC Ge 2200 Bergquist Dr Ste 1
Lackland Afb
San Antonio, TX 78236-5300

Phone

(210) 292-5875

Fax

(210) 292-5844

NPI assigned

Jun 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles Justin Haggerty, M.D.

Title

Ortho Resident

Phone

(210) 292-5875

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043416878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13807 RIVERBANK PASS",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780233638",
            "telephone_number": "210-292-5875",
            "fax_number": "210-292-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WHMC GE 2200 BERGQUIST DR STE 1",
            "address_2": "LACKLAND AFB",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-292-5875",
            "fax_number": "210-292-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U.S. AIR FORCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAGGERTY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "ORTHO RESIDENT",
        "authorized_official_telephone_number": "210-292-5875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "IN",
            "license": "01060712A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.