COMANCHE COUNTY HEALTHCARE CORP NPI 1558472506

NPI Information

  • NPI: 1558472506
  • Provider Name: COMANCHE COUNTY HEALTHCARE CORP
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • Doing Business As: MEMORIAL MEDICAL GROUP SURGERY
  • CLIA Number: 37D2301578
  • Address: 110 NW 31ST ST
    3RD FLOOR
    LAWTON, OK
    ZIP 73505
  • Phone: (580) 510-7042

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NPI Details

COMANCHE COUNTY HEALTHCARE CORP is a vascular surgery surgery in Lawton, OK. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. COMANCHE COUNTY HEALTHCARE CORP NPI is 1558472506. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memorial Medical Group Surgery.

The provider's business location address is:

110 NW 31ST ST
3RD FLOOR
LAWTON, OK
ZIP 73505-100
Phone: (580) 510-7042
Fax: (580) 510-7044

The provider's authorized official is Brent Smith .
The authorized official title is Cfo and has the following contact phone number (580) 355-8620.

The CLIA number assigned to this NPI record is 37D2301578 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 5/8/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular Surgery14399OKLAHOMAYes

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: 11/21/2025

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