Comanche County Healthcare
Organization Active NPI Family Medicine Physician · Waurika, OK
NPI 1235159229 · NPPES record last updated May 8, 2015
Key facts
- NPI
- 1235159229
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2176 (OK)
- Legal business name
- COMANCHE COUNTY HEALTHCARE
- Practice address
- Hwy 81 and 70
Waurika, OK 73573 - Phone
- (580) 228-3669
- Fax
- (580) 228-2529
- NPI assigned
- Jul 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Brent Smith
- Title
- Cfo
- Phone
- (580) 355-8620
Other NPIs on the same Medicare enrollment 39
Practitioners 1
-
Jose Meza, D.O
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
102 NW 31st St
Lawton, OK 73505
Phone (580) 353-6790
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 2176 | OK | Yes |
Addresses
Primary practice location
Hwy 81 and 70
Waurika, OK 73573
Mailing address
PO Box 785
Lawton, OK 73502
Phone (580) 357-9984
Other names
- MEMORIAL MEDICAL GROUP WAURIKA AMILY MEDICAL CLINIC
Other providers in Waurika, OK
- Randi Lynne Berry
- Sheila Marie Black
- City of Waurika
- Thomas Ray Crow
- Dr. Chad G Williams
- Duncan Regional Hospital Inc
- Duncan Regional Hospital Inc
- Duncan Regional Hospital, Inc
All providers in Waurika, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.