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COMANCHE COUNTY HOSPITAL AUTHORITY NPI 1346266731


NPI Information

NPI: 1346266731
Provider Name: COMANCHE COUNTY HOSPITAL AUTHORITY

Doing Business As: MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 37D0472122

Address:
3201 W GORE BLVD
SUITE 304
LAWTON, OK
ZIP 73505
Phone: (580) 353-6760
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COMANCHE COUNTY HOSPITAL AUTHORITY is a federally qualified health center (fqhc) clinic center in Lawton, OK. COMANCHE COUNTY HOSPITAL AUTHORITY NPI is 1346266731. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memorial Medical Group Internal Medicine Clinic.

The provider's business location address is:

3201 W GORE BLVD
SUITE 304
LAWTON, OK
ZIP 73505
Phone: (580) 353-6760
Fax: (580) 248-3760

The provider's authorized official is Julie Kilgore .
The authorized official title is Credentialing and has the following contact phone number (580) 585-5443.

The CLIA number assigned to this NPI record is 37D0472122 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 12/14/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine17722OKLAHOMANo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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