MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC – NPI #1346266731
Clinic/Center

MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC is an AHC clinic located in LAWTON, OK. NPPES has assigned the NPI number 1346266731 to MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC on July 15, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC” is a dba name, the actual legal business name for this organization is COMANCHE COUNTY HOSPITAL AUTHORITY. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 2 years ago on Jan 10, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC below.

NPI Profile for
COMANCHE COUNTY HOSPITAL AUTHORITY

NPI Number
1346266731
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing Business As (dba): MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC
Primary location
3201 W GORE BLVD
SUITE 304
LAWTON, OK 73505
Phone: (580) 353-6760 Fax: (580) 248-3760
Mailing address
PO BOX 785
LAWTON, OK 73502
Phone: (580) 357-9984 Fax: (580) 357-3277
Organization Subpart
No
Authorized Official
BRENT SMITH
CEO
Phone: (580) 585-5511
Updated
Certification Date
Jan 10, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
207R00000X
- Internal Medicine		 OK 17722

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.