Organization
COMANCHE COUNTY HEALTHCARE
Active
Other names
MEMORIAL MEDICAL GROUP INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BLACKMON (CFO)
(580) 355-8620
Entity
Organization
Contact information
Practice address
3201 W GORE BLVD, SUITE 202, LAWTON, OK 73505-6378
(580) 355-6731
(580) 250-5806
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18140
OK
Other
Enumeration date
07/20/2006
Last updated
11/13/2012
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