NPI 1003051210

US Army

Organisation Military/U.S. Coast Guard Outpatient Clinic/Center Fayetteville, NC

Practice location

Address: 5587 Lockridge Road, Fayetteville, NC 28311
Phone: (910) 988-6117
Mailing address: 5587 Lockridge Rd, Fayetteville, NC 28311-0240

Authorised official

Name: Christopher Scott Brackman
Title: PA
Phone: (910) 988-6117

Registered specialties

Military/U.S. Coast Guard Outpatient Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QM1100X Licence 0010-01314 (NC)

Other Clinic/Center providers in North Carolina →

Registry record

NPI: 1003051210
Entity type: Organization
NPI issued: 3 Dec 2008
Record last updated: 3 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.