Dexter Eli Vanderpool, IDMT
Military Health Care Provider, Independent Duty Medical Technicians in Eglin Afb, FL. Individual provider (NPI-1).
NPI number1760625974
StatusActive
Last updated in NPPESApr 17, 2009
Details
- NPI
- 1760625974
- Entity type
- Individual (NPI-1)
- Name
- Mr. Dexter Eli Vanderpool
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2009
- Last updated
- Apr 17, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | – | Yes |
Practice location
101 Griffin WayEglin Afb, FL 32542
Phone 850-883-4487
Mailing address
101 Griffin WayEglin Afb, FL 32542
Phone 850-883-4487
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