NPIMap

Organization Active NPI

Comanche County Healthcare Corp

Doing business as Memorial Medical Group Internal Medicine

  • Internal Medicine Physician
  • Lawton, OK
National Provider Identifier
1891039517
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMANCHE COUNTY HEALTHCARE CORP
Doing business as
Memorial Medical Group Internal Medicine
Practice address
3201 W Gore Blvd
Suite 202
Lawton, OK 73505-6378
Phone
(580) 355-6731
Fax
(580) 250-5806
NPI assigned
Nov 19, 2012
Last updated
Nov 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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 Primary

Addresses

Primary practice location

3201 W Gore Blvd
Suite 202
Lawton, OK 73505-6378

Mailing address

PO Box 785
Lawton, OK 73502-0785
Phone (580) 357-9984

Other names 1

  • Memorial Medical Group Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Karen Schafer DO34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1891039517",
    "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": "735020785",
            "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 202",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056378",
            "telephone_number": "580-355-6731",
            "fax_number": "580-250-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Group 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 Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.