Wilford Hall Usaf Medical Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

F2298 Issued in TX

Legal business name

WILFORD HALL USAF MEDICAL CENTER

Practice address

2200 Bergquist Dr
Lackland a F B, TX 78236-9907

Phone

(210) 292-7361

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Darlon B Jackson

Title

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730257429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 TRILLIUM LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132513",
            "telephone_number": "210-342-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILFORD HALL USAF MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DARLON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "210-292-6707"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "F2298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darinda Lee Whitefield, IDMT
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Carl L Williams, M.D.
• Joshua Dale Wilson, PH.D.
• Kondi Wong, M.D.
• Amy Woods
• William Geoffrey Wyatt, DPM

• Exclusive Provider Organization in Lackland a F B, TX
• Providers in Lackland a F B, TX by specialty
• Exclusive Provider Organization 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.