Doctor Name: | HELEN ANN SANTIAGO |
NPI Number: | 1003983354 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTR |
License Number: | OT001674 |
Business Practice Address: | 300 W Hospital Road Eisenhower Army Medical Center Fort Gordon, GA - 309055741 |
Business Phone Number: | 7067872720 |
Business Fax Number: | 7067878176 |
Mailing Address: | 300 W Hospital Road, Eisenhower Army Medical Center FORT GORDON |
State: | GA |
Postal Code: | 309055741 |
Phone Number: | 7067872720 |
Fax Number: | 7067878176 |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | OT001674 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |