COMANCHE COUNTY HEALTHCARE CORPORATION (NPI# 1609315308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609315308 |
| Entity Type | Organization |
| Organization Name | COMANCHE COUNTY HEALTHCARE CORPORATION |
| Other Organization Name | MMG EAR, NOSE AND THROAT CLINIC |
| Practice Address |
3201 W Gore Blvd Suite 103 Lawton OK 73505-6378 |
| Mailing Address |
Po Box 785 Lawton OK 73502-0785 |
| Practice Telephone | 5802506555 |
| Practice Fax Number | 5803545942 |
| Mailing Telephone | 5803579984 |
| Mailing Fax Number | 5803573277 |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | BRENT SMITH (CEO) |
| Authorized Official Telephone | 5803558620 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MMG Ear, Nose and Throat Clinic | 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 |
| 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 |
| 1982025250 | Comanche County Healthcare Corporation | Family Medicine | 901 Sw Goodyear Blvd, Lawton, OK 73505-9755 | 2014-01-03 |
| Street Address |
3201 W GORE BLVD SUITE 103 |
| 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 |
| 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 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780638502 | Allergy Ear Nose and Throat Institute Pllc | Otolaryngology | 4920 Sw Lee Blvd, Lawton, OK 73505-8339 | 2006-05-19 |
| 1083616247 | Stephen W Snell IIi | Otolaryngology | 5402 Sw Lee Blvd, Lawton, OK 73505-9521 | 2005-06-01 |
| 1174844864 | Chad D. Willis, D.o., P.C. | Otolaryngology | 5402 Sw Lee Blvd, Lawton, OK 73505-9521 | 2010-06-16 |
| 1558457275 | Timothy N Kaiser | Otolaryngology | 5402 Sw Lee Blvd, Lawton, OK 73505-9521 | 2006-10-04 |
| 1205878691 | Ent of Oklahoma Profit Sharing Plan | Otolaryngology | 5402 Sw Lee Blvd, Lawton, OK 73505-9521 | 2006-06-12 |
| 1083660369 | Dale B Smith | Otolaryngology | 4920 Sw Lee Blvd, Lawton, OK 73505-8339 | 2006-05-26 |
| 1568464725 | Alan E Aycock | Otolaryngology | 5402 Sw Lee Blvd, Lawton, OK 73505-9521 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871056671 | Perry Santos, M.d., P.C. | Otolaryngology | 3435 Nw 56th St, Bldg A, Suite 412, Oklahoma City, OK 73112-4448 | 2019-04-09 |
| 1598292419 | Vikram Gopal Ramjee | Otolaryngology | 800 Stanton L Young Blvd Ste 1464, Oklahoma City, OK 73104-5018 | 2017-05-23 |
| 1649657263 | Lindsey B Stull | Otolaryngology | 800 Stanton L Young Blvd # 1464, Oklahoma City, OK 73104-5018 | 2015-05-04 |
| 1457768376 | Keren Bartal | Otolaryngology | G. Rainey Williams Pavilion 1290, Oklahoma City, OK 73126 | 2014-07-14 |
| 1255687638 | Richmond Jay Brownson | Otolaryngology | 7906 E 55th Street, Tulsa, OK 74145 | 2012-08-03 |
| 1952667750 | Steven Craig Quattlebaum II | Otolaryngology | 2017 W I 35 Frontage Rd Ste 140, Edmond, OK 73013-8555 | 2012-04-05 |
| 1518233758 | Edward T El Rassi | Otolaryngology | 800 Stanton L Young Blvd Ste 1400, Oklahoma City, OK 73104 | 2012-03-30 |
| 1871864439 | Boogers R Us Pllc | Otolaryngology | 730 Finley Dr, Ada, OK 74820-5392 | 2012-01-13 |
| 1972737641 | Tulsa Only Choice Inc | Otolaryngology | 2705 E Skelly Dr Ste 111, Tulsa, OK 74105-6239 | 2009-05-11 |
| 1497979686 | Tulsa Ear Nose and Throat Center, PC | Otolaryngology | 8803 S 101st East Ave Ste 165, Tulsa, OK 74133-5750 | 2007-04-12 |
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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.