Wilford Hall Medical Center

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

S14188 Issued in TX

Legal business name

WILFORD HALL MEDICAL CENTER

Practice address

2200 Bergquist Dr
Attn: Credentials (CMC)
Lackland AFB,, TX 78236-5300

Phone

(210) 292-6707

Fax

(210) 292-7964

NPI assigned

Jan 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Darlon Jackson, GS-09

Title

Supervisor Credentials Manager

Phone

(210) 292-6707

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598743825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "ATTN: CREDENTIALS (CMC)",
            "city": "LACKLAND AFB,",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-292-6707",
            "fax_number": "210-292-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "ATTN: CREDENTIALS (CMC)",
            "city": "LACKLAND AFB,",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-292-6707",
            "fax_number": "210-292-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILFORD HALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DARLON",
        "authorized_official_title_or_position": "SUPERVISOR CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "210-292-6707",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "GS-09"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "S14188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun Christopher White, PHARM.D.
• Darinda Lee Whitefield, IDMT
• Heather Lynn Widell, PA-C
• Chester Allen Wilds, IDMT
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Usaf Medical Center
• Willford Hall Medical Ctr (Lackland Refill Phcy)

• Critical Access Hospital in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Critical Access Hospital in Texas

• 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.