Organization
COMANCHE COUNTY HOSPITAL AUTHORITY
Active
Organization
COMANCHE COUNTY HOSPITAL AUTHORITY
Active
Other names
Memorial Medical Group Internal Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SMITH (CEO)
(580) 585-5511
Entity
Organization
Contact information
Practice address
3201 W GORE BLVD, SUITE 304, LAWTON, OK 73505
(580) 353-6760
(580) 248-3760
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17722
OK
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/15/2006
Last updated
01/10/2024
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