Healthcare Provider Details

I. General information

NPI: 1346172442
Provider Name (Legal Business Name): COMANCHE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E JOSEPHINE AVE
FREDERICK OK
73542-2220
US

IV. Provider business mailing address

319 E JOSEPHINE AVE
FREDERICK OK
73542-2220
US

V. Phone/Fax

Practice location:
  • Phone: 580-355-7545
  • Fax: 580-354-5900
Mailing address:
  • Phone: 580-355-7545
  • Fax: 580-354-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN MCAVOY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 580-355-8620