Provider Demographics
NPI:1174972772
Name:USAF 81ST MEDICAL GROUP
Entity type:Organization
Organization Name:USAF 81ST MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-377-6550
Mailing Address - Street 1:81MSGS/SGCQ 301 FISHER ST,
Mailing Address - Street 2:RM 5A127
Mailing Address - City:KEESLER AFB
Mailing Address - State:MS
Mailing Address - Zip Code:39534
Mailing Address - Country:US
Mailing Address - Phone:228-377-6550
Mailing Address - Fax:
Practice Address - Street 1:81MSGS/SGCQ 301 FISHER ST,
Practice Address - Street 2:RM 5A127
Practice Address - City:KEESLER AFB
Practice Address - State:MS
Practice Address - Zip Code:39534
Practice Address - Country:US
Practice Address - Phone:228-377-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital