| Organization Name: | U.S. AIR FORCE |
| NPI Number: | 1043416878 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES JUSTIN HAGGERTY (ORTHO RESIDENT) |
| Mailing Address: | Whmc Ge 2200 Bergquist Dr Ste 1 Lackland Afb San Antonio |
| State: | TX US |
| Postal Code: | 782365300 |
| Phone Number: | 2102925875 |
| Fax Number: | 2102925844 |
| NPI Enumeration Date: | 06/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | 01060712A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |