Provider Demographics
NPI:1639332794
Name:48 MDG
Entity Type:Organization
Organization Name:48 MDG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH FLIGHT COMMANDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KESSLER-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-210-2463
Mailing Address - Street 1:PSC 41 BOX 3799
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0038
Mailing Address - Country:US
Mailing Address - Phone:402-210-2463
Mailing Address - Fax:
Practice Address - Street 1:48 MDOS/SGOW
Practice Address - Street 2:UNIT 5210 BOX 230
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461
Practice Address - Country:US
Practice Address - Phone:0163-852-8603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 58482865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital