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Comanche County Healthcare Corporation

Organization Active NPI Rheumatology Physician · Lawton, OK

NPI 1124790233 · NPPES record last updated Sep 28, 2021

Key facts

NPI
1124790233
Entity type
Organization (NPI type 2)
Primary specialty
Rheumatology Physician 207RR0500X
Legal business name
COMANCHE COUNTY HEALTHCARE CORPORATION
Practice address
3201 W Gore Blvd Ste 104
Lawton, OK 73505-6350
Phone
(580) 250-6659
NPI assigned
Sep 28, 2021
Organization subpart
No

Authorized official

Name
Brent Smith
Title
Ceo
Phone
(580) 585-5522

Corporate family (same tax ID) 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

National Provider Directory

Tax ID family
Troy L Harden DO (34 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RR0500X Yes

Addresses

Primary practice location

3201 W Gore Blvd Ste 104
Lawton, OK 73505-6350

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (580) 585-5443

Other names

  • Memorial Medical Group Rheumatology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2021.

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1124790233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-585-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD STE 104",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056350",
            "telephone_number": "580-250-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-585-5522"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Group Rheumatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

All providers in Lawton, OK · Rheumatology Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.