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Organization
COMANCHE COUNTY HEALTHCARE
Active
Organization
COMANCHE COUNTY HEALTHCARE
Active
Other names
MEMORIAL MEDICAL GROUP FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SMITH (CFO)
(580) 355-8620
Entity
Organization
Contact information
Practice address
3811 W GORE BLVD, SUITE 2, LAWTON, OK 73505-6328
(580) 585-5550
(580) 585-5551
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16850
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100205240A
—
OK
Enumeration date
07/27/2006
Last updated
05/08/2015
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