Organization · Type 2 NPI

Eisenhower Army Medical Center

Military/U.S. Coast Guard Outpatient Clinic/Center · Fort Gordon, GA

NPI number 1396949657 Active

Practice location

Building 25501, Brainard Avenue
Fort Gordon, GA 30905

Mailing address

300 W Hospital Rd Bldg W, Attn Mchf-Pad
Fort Gordon, GA 30905-5741

Specialties and licenses

TaxonomyCodeLicense
Military/U.S. Coast Guard Outpatient Clinic/Center Primary 261QM1100XNone 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…

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About NPI 1396949657

Eisenhower Army Medical Center's National Provider Identifier is 1396949657, issued on Jun 12, 2007. The primary taxonomy on file is Military/U.S. Coast Guard Outpatient Clinic/Center (261QM1100X), and the practice location is in Fort Gordon, GA. The record was last updated on Jan 29, 2013.