Organization
COMANCHE COUNTY HOSPITAL AUTHORITY
Active
Other names
MMG Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT SMITH (CEO)
(580) 355-8620
Entity
Organization
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(888) 638-7800
Mailing address
PO BOX 2309, SECTION 6, LAWTON, OK 73502-2309
(888) 638-7800
(817) 731-7774
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
12/06/2012
Last updated
10/17/2016
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