NPIMap

Organization Active NPI

Comanche County Healthcare

Doing business as Bobby Abraham MD Internal Medicine

  • Internal Medicine Physician
  • Lawton, OK
National Provider Identifier
1053530568
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25416 Issued in OK
Legal business name
COMANCHE COUNTY HEALTHCARE
Doing business as
Bobby Abraham MD Internal Medicine
Practice address
3201 W Gore Blvd
Suite 105
Lawton, OK 73505
Phone
(580) 510-7077
Fax
(580) 510-7057
NPI assigned
Apr 24, 2007
Last updated
Jan 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Blackmon
Title
Cfo
Phone
(580) 355-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25416 OK Primary

Addresses

Primary practice location

3201 W Gore Blvd
Suite 105
Lawton, OK 73505

Mailing address

PO Box 785
Lawton, OK 73502
Phone (580) 357-9984

Other names 1

  • BOBBY ABRAHAM MD INTERNAL MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000742 OK Part B Supplier - Clinic/Group Practice 0749192433 Receives reassigned benefits from 166 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawton, OK; Oklahoma City, OK; Pawhuska, OK; Snyder, OK; Tahlequah, OK; The Village, OK; Edmond, OK; Frederick, OK

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1053530568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73502",
            "telephone_number": "580-357-9984",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD",
            "address_2": "SUITE 105",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-510-7077",
            "fax_number": "580-510-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "BLACKMON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-355-8620"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "25416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOBBY ABRAHAM MD INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.