Organization · Type 2 NPI
27th Special Ops Medgrp-Cannon
Military/U.S. Coast Guard Outpatient Clinic/Center · Cannon Afb, NM
Practice location
208 W Casablanca Ave, 27 Mdss Sgsr
Cannon Afb, NM 88103-5009
Fax (505) 784-7749
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military/U.S. Coast Guard Outpatient Clinic/Center Primary | 261QM1100X | None listed |
| Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | 261QM1101X | None listed |
| Military/U.S. Coast Guard Pharmacy | 332000000X | None listed |
Military/U.S. Coast Guard Outpatient Clinic/Center: The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as exam…
15 other providers at this address
- Andrew SpringsteadIndependent Duty Medical Technicians Cannon Afb, NM NPI 1639313125
- Daniel Lewis Tyson, IDMTIndependent Duty Medical Technicians Clovis, NM NPI 1245474667
- David A. Sarnow, MD, MPHAerospace Medicine Physician Cannon Afb, NM NPI 1609914431
- Desiree Anderson, IDMTIndependent Duty Medical Technicians Cannon Afb, NM NPI 1295093912
- Donald Joseph Trigg, PA-CPhysician Assistant Cannon Afb, NM NPI 1104071729
- Jeremiah Edwin Johnson, R.D. MPHRegistered Dietitian Cannon Afb, NM NPI 1558386979
- Jessica Marie Pothast, PharmDPharmacist Cannon Afb, NM NPI 1912139668
- Katherine Ann Craft, RD, LDRegistered Dietitian Clovis, NM NPI 1861902041
- Katherine Milam, DOFamily Medicine Physician Cannon Afb, NM NPI 1306228325
- Lindsay Vincent, IDMTIndependent Duty Medical Technicians Cannon Afb, NM NPI 1083844054
- Marla Dianne Buckles, FNPFamily Nurse Practitioner Clovis, NM NPI 1043208838
- Robert Dale Bitner, PAPhysician Assistant Clovis, NM NPI 1851372858
About NPI 1285606384
27th Special Ops Medgrp-Cannon's National Provider Identifier is 1285606384, issued on Feb 2, 2006. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in Cannon Afb, NM. The record was last updated on Jun 17, 2025.