# COMANCHE COUNTY HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEMORIAL MEDICAL GROUP FAMILY MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174547632
- **Authorized official:** MR. DAVID BLACKMON (CFO)
- **Authorized official phone:** (580) 355-8620

## Contact information

- **Practice address:** 3201 W GORE BLVD, SUITE 105, LAWTON, OK 73505-6378
- **Practice address phone:** (580) 510-7077
- **Practice address fax:** (580) 510-7057
- **Mailing address:** PO BOX 785, LAWTON, OK 73502
- **Mailing address phone:** (580) 357-9984
- **Mailing address fax:** (580) 357-3277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22720 | OK | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 09/24/2013