| Organization Name: | DDEAMC |
| NPI Number: | 1740446905 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLYN L. JONES (LPN) |
| Mailing Address: | 300 W Hospital Rd Fort Gordon |
| State: | GA US |
| Postal Code: | 309055741 |
| Phone Number: | 7067879253 |
| Fax Number: | 7067879356 |
| NPI Enumeration Date: | 08/06/2008 |
| NPI Last Update Date: | 08/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | LPN024837 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |