| Organization Name: | 81ST MEDICAL GROUP |
| NPI Number: | 1023302957 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARAMIE JAY RICHMOND (PHYSICIAN ASSISSTANT) |
| Mailing Address: | 301 Fisher St 81 Mdos Sgof Keesler Afb |
| State: | MS US |
| Postal Code: | 395342508 |
| Phone Number: | 2283760440 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2011 |
| NPI Last Update Date: | 06/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |