COMANCHE COUNTY HEALTHCARE CORPORTATION (NPI# 1174901102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174901102 |
| Entity Type | Organization |
| Organization Name | COMANCHE COUNTY HEALTHCARE CORPORTATION |
| Other Organization Name | MMG PEDIATRICS |
| Practice Address |
3201 W Gore Blvd Suite G1 Lawton OK 73505-6378 |
| Mailing Address |
Po Box 785 Lawton OK 73502-0785 |
| Practice Telephone | 5805107070 |
| Mailing Telephone | 5803579984 |
| Mailing Fax Number | 5803573277 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-06-23 |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MMG Pediatrics | Doing Business As Name - Organization |
| Street Address |
3201 W GORE BLVD SUITE G1 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-6378 |
| 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 |
| 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 |
| 1558675785 | Neurosurgery Center of Southwest Oklahoma Inc | Neurological Surgery | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2010-07-29 |
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| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265763437 | Quality Care Pediatrics | Pediatrics | 5606 Sw Lee Blvd Ste 306, Lawton, OK 73505-9688 | 2010-01-27 |
| 1649348558 | Dolores Ngozi Ifezue | Pediatrics | Lawton Indian Hospital, 1515 Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2006-11-30 |
| 1477539740 | Minda Unidad Roan | Pediatrics | 110 Nw 31st St Ste 201, Lawton, OK 73505-6100 | 2005-12-19 |
| 1750913117 | Wonder Kids Specialty Pediatrics Pllc | Pediatrics | 5606 Sw Lee Blvd Ste 201, Lawton, OK 73505-9651 | 2020-02-04 |
| 1427481449 | Ahmed Mohamed Abdin | Pediatrics | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2013-08-13 |
| 1609181239 | Folake Esther Olaosebikan | Pediatrics | 5606 Sw Lee Blvd, Suite 201, Lawton, OK 73505-9688 | 2010-08-06 |
| 1811208945 | Hokehe Effiong | Pediatrics | 3811 W Gore Blvd, Lawton, OK 73505-6328 | 2010-06-23 |
| 1134455074 | Southwestern Pediatrics LLC | Pediatrics | 5606 Sw Lee Blvd, Suite 201, Lawton, OK 73505-9688 | 2009-10-28 |
| 1104053776 | Laura White | Pediatrics | 4202 Sw Lee Blvd, Building B, Suite 100, Lawton, OK 73505-8343 | 2009-06-22 |
| 1003064478 | Laura Coleman, Md Pllc | Pediatrics | 5366 Nw Cache Rd, Suite 6, Lawton, OK 73505-3335 | 2008-08-28 |
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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.