# COMANCHE COUNTY HEALTHCARE CORP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMANCHE COUNTY HEALTHCARE CORP
- **Other names:** MEMORIAL MEDICAL GROUP FAMILY PRACTICE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659647501
- **Legal business name:** COMANCHE COUNTY HEALTHCARE CORP
- **Authorized official:** DAVID BLACKMON (CFO)
- **Authorized official phone:** (580) 355-8620

## Contact information

- **Practice address:** 3201 W GORE BLVD, STE 300, LAWTON, OK 73505-6378
- **Practice address phone:** (580) 585-5549
- **Practice address fax:** (580) 354-5911
- **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 | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2012
- **Last updated:** 03/26/2012