COMANCHE COUNTY HEALTHCARE CORP NPI 1558472506

NPI Information

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:

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