Organization
COMANCHE COUNTY HOSPITAL AUTHORITY
Active
Other names
MEMORIAL MEDICAL GROUP FAMILY MEDICINE, LCHC Family Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE KILGORE (CREDENTIALING)
(580) 585-5443
Entity
Organization
Contact information
Practice address
3201 W GORE BLVD, SUITE 301, LAWTON, OK 73505-6378
(580) 248-8225
(580) 248-8919
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5443
(580) 585-5553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11906
OK
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
12/14/2020
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