Wilford Hall Medical Center

Primary specialty

Military HospitalTaxonomy code 286500000X

License

MD057195L Issued in PA

Legal business name

WILFORD HALL MEDICAL CENTER

Practice address

2200 Bergquist Dr
Suite 1 Attn: Credentials CMC
Lackland a F B, TX 78236-9907

Phone

(210) 292-6707

Fax

(210) 292-7964

NPI assigned

Mar 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. 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": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912968595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-6408",
            "fax_number": "210-292-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1 ATTN: CREDENTIALS CMC",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-6707",
            "fax_number": "210-292-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILFORD HALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "PA",
            "license": "MD057195L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun Christopher White, PHARM.D.
• Darinda Lee Whitefield, IDMT
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Medical Center
• Wilford Hall Usaf Medical Center
• Carl L Williams, M.D.
• Joshua Dale Wilson, PH.D.
• Kondi Wong, M.D.
• Amy Woods

• Military Hospital in Lackland a F B, TX
• Providers in Lackland a F B, TX by specialty
• Military 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.