375th Medgrp-Scott

NPI #1861478448 in Scott Afb, Illinois

Provider Information

NPI Number: 1861478448
Entity Type: Organization
Organization Name: 375th Medgrp-Scott
Subpart: Yes (part of a larger organization)
Parent Organization: 375TH MEDGRP-SCOTT
Primary Specialty: Military Hospital
Enumeration Date: Dec 15, 2005
Last Updated: May 29, 2025

Practice Location

Address: 310 W LOSEY ST
City: Scott Afb
State: Illinois
ZIP Code: 62225-5250
Phone: (618) 256-6267

Authorized Official

Name: DR. BRUCE JAY GARDNER II, M.D.
Title: RESIDENT PHYSICIAN
Phone: (618) 256-6267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Hospital	286500000X	Primary

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