MEDICARE: COMANCHE COUNTY HEALTHCARE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	3110	OK

General Provider Information

NPI Number	:	1770500753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMANCHE COUNTY HEALTHCARE CORPORATION

Provider Business Mailing Address
First Line	:	3401 W GORE BLVD
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-6332
Country	:	US
Telephone Number	:	580-355-8620
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 W GORE BLVD STE 300
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-6350
Country	:	US
Telephone Number	:	580-248-5255
Fax Number	:	580-248-2036

Authorized Official
Title or Position	:	CEO
Name	:	BRENT SMITH
Credential	:
Telephone Number	:	580-585-5522

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	01/22/2026

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