Organization
COMANCHE COUNTY HOSPITAL AUTHORITY SOUTHWEST RADIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BLACKMON (CFO)
(580) 355-8699
Entity
Organization
Contact information
Practice address
11447 DUTCH IRIS DR, RIVERVIEW, FL 33578-3728
(580) 585-2717
Mailing address
PO BOX 2309, LAWTON, OK 73502-2309
(800) 945-2455
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
115285
FL
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/14/2009
Last updated
06/07/2013
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