COMANCHE COUNTY HEALTHCARE CORPORATION (NPI# 1154345619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154345619 |
| Entity Type | Organization |
| Organization Name | COMANCHE COUNTY HEALTHCARE CORPORATION |
| Other Organization Name | MMG UROLOGY |
| Practice Address |
3201 W Gore Blvd Suite 201 Lawton OK 73505 |
| Mailing Address |
Po Box 785 Lawton OK 73502 |
| Practice Telephone | 5803572261 |
| Practice Fax Number | 5803572263 |
| Mailing Telephone | 5803579984 |
| Mailing Fax Number | 5803573277 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | BRENT SMITH (CFO) |
| Authorized Official Telephone | 5803558620 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 19658 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100810030L | 05 |
| Other Name | Type Code |
|---|---|
| MMG Urology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629604376 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd Ste G1, Lawton, OK 73505-6308 | 2020-03-13 |
| 1326558180 | Comanche County Healthcare Corporation | Psychiatry & Neurology | 3201 W Gore Blvd Ste 300, Lawton, OK 73505-6350 | 2017-10-06 |
| 1306863287 | Comanche County Healthcare Corporation | Obstetrics & Gynecology | 102 Nw 31st St, Lawton, OK 73505 | 2006-07-16 |
| 1255871497 | Comanche County Healthcare Corporation | Internal Medicine | 3106 Nw Arlington Ave, Lawton, OK 73505-6123 | 2017-03-07 |
| 1114466455 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2017-02-20 |
| 1609315308 | Comanche County Healthcare Corporation | Otolaryngology | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2017-02-15 |
| 1134586563 | Comanche County Healthcare Corporation | Internal Medicine | 6401 Sw Lee Blvd, Lawton, OK 73505-9678 | 2016-01-15 |
| 1548648579 | Comanche County Healthcare Corporation | Podiatrist | 110 Nw 31st St, 2nd Floor, Lawton, OK 73505-6100 | 2015-05-11 |
| 1164800348 | Comanche County Healthcare Corporation | Internal Medicine | 4202 Sw Lee Blvd, Bldg A Ste 104, Lawton, OK 73505-8300 | 2015-05-08 |
| 1891195590 | Comanche County Healthcare Corporation | Nurse Practitioner | 4411 W Gore Blvd, Suite A2, Lawton, OK 73505-6016 | 2014-08-29 |
| Street Address |
3201 W GORE BLVD SUITE 201 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144227273 | Prabhudas Khodidas Patel | Surgery | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2005-07-05 |
| 1245744986 | Stephanie Morris | Nurse Practitioner | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2017-11-16 |
| 1114466455 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2017-02-20 |
| 1609315308 | Comanche County Healthcare Corporation | Otolaryngology | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2017-02-15 |
| 1174901102 | Comanche County Healthcare Corportation | Pediatrics | 3201 W Gore Blvd, Suite G1, Lawton, OK 73505-6378 | 2015-05-11 |
| 1780027433 | Amber Lee Cobia | Physical Therapist | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2013-04-12 |
| 1891039517 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 202, Lawton, OK 73505-6378 | 2012-11-19 |
| 1629328786 | Sherif Sayed Ismail Md PC | Skilled Nursing Facility | 3201 W Gore Blvd, Suite 105, Lawton, OK 73505-6378 | 2012-09-17 |
| 1659647501 | Comanche County Healthcare Corp | Family Medicine | 3201 W Gore Blvd, Ste 300, Lawton, OK 73505-6378 | 2012-03-26 |
| 1164736351 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2010-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215047865 | Michael Ervin Kuglitsch | Urology | 3414 Nw Cache Rd Ste F, Lawton, OK 73505-3878 | 2006-08-30 |
| 1760997092 | Lawton Urology | Urology | 3414 Nw Cache Rd Ste F, Lawton, OK 73505-3878 | 2017-12-08 |
| 1104330943 | Kuglitsch Enterprises, Inc | Urology | 3414 Nw Cache Rd Ste F, Lawton, OK 73505-3878 | 2017-11-30 |
| 1508935289 | Robert C Gose | Urology | 3201 W Gore Blvd, Suite 201, Lawton, OK 73505 | 2006-11-07 |
| 1497743405 | Scott Lewis Michener | Urology | 3201 W Gore Blvd, Suite 201, Lawton, OK 73505 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194338426 | Davis Urology, Pllc | Urology | 13509 N Meridian Ave Ste 6, Oklahoma City, OK 73120-8396 | 2020-08-26 |
| 1073146304 | Roy W Bankhead Md PC | Urology | 5700 N Portland Ave Ste 100, Oklahoma City, OK 73112-1662 | 2020-02-14 |
| 1851877567 | Richard E. Herlihy Md, PC | Urology | 4140 W Memorial Rd Ste 611, Oklahoma City, OK 73120-8300 | 2018-07-16 |
| 1306383849 | Urology Affiliates of Oklahoma LLC | Urology | 5300 N Grand Blvd Ste 200, Oklahoma City, OK 73112-5517 | 2017-01-23 |
| 1285015057 | Caitlin Shepherd | Urology | 722 Nw 28th St, Oklahoma City, OK 73103-1009 | 2015-06-17 |
| 1295174969 | Joseph Fernando Rodriguez IIi | Urology | 920 Stanton L Young Blvd # Wp3150, Oklahoma City, OK 73104-5036 | 2013-06-17 |
| 1003159773 | Philip D. Diggdon Sr. | Urology | 3424 E. 65 St, Tulsa, OK 74136 | 2013-04-01 |
| 1811247885 | Melanie Nyeh Ketchandji | Urology | 1145 South Utica Avenue, Suite 202, Tulsa, OK 74104-4022 | 2012-09-17 |
| 1992055990 | Kathryn Griffin Cunningham | Urology | 4140 W Memorial Rd Ste 208, Oklahoma City, OK 73120 | 2012-09-17 |
| 1477847374 | Bhalaajee Meenakshi-sundaram | Urology | 1200 Childrens Ave # 7d, Oklahoma City, OK 73104 | 2011-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.