# COMANCHE COUNTY HEALTHCARE CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Memorial Medical Group Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558472506
- **Authorized official:** MR. BRENT SMITH (CFO)
- **Authorized official phone:** (580) 355-8620

## Contact information

- **Practice address:** 110 NW 31ST ST, 3RD FLOOR, LAWTON, OK 73505-6100
- **Practice address phone:** (580) 510-7042
- **Practice address fax:** (580) 510-7044
- **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 |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 14399 | OK | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 05/08/2015