# COMANCHE COUNTY HEALTHCARE CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Memorial Medical Group Carnegie Family Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346269925
- **Authorized official:** JOE KIP CUMMINS (CFO)
- **Authorized official phone:** (580) 355-8620

## Contact information

- **Practice address:** 102 N BROADWAY, CARNEGIE, OK 73015
- **Practice address phone:** (580) 654-2500
- **Practice address fax:** (580) 654-1488
- **Mailing address:** PO BOX 785, LAWTON, OK 73502-0785
- **Mailing address phone:** (580) 357-9984
- **Mailing address fax:** (580) 357-3277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2525 | OK | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 10/25/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100810030L | — | OK |