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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