Provider Demographics
NPI:1659559078
Name:USAF
Entity Type:Organization
Organization Name:USAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-782-8010
Mailing Address - Street 1:PSC 2 BOX 711
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96264-0008
Mailing Address - Country:US
Mailing Address - Phone:315-782-8010
Mailing Address - Fax:315-782-0676
Practice Address - Street 1:UNIT 2022
Practice Address - Street 2:KUNSAN AB
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96264-2022
Practice Address - Country:US
Practice Address - Phone:315-782-8010
Practice Address - Fax:315-782-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2009-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital