| Organization Name: | US ARMY |
| NPI Number: | 1881788834 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WANDA CARMEN JIRAU-ROSALY (FAMILY PHYSICIAN) |
| Mailing Address: | 42 Ne Pheasant Ln Lawton |
| State: | OK US |
| Postal Code: | 735078850 |
| Phone Number: | 5805292142 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 01059043A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| 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. |