Healthcare Provider Details

I. General information

NPI: 1174545834
Provider Name (Legal Business Name): COMANCHE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 SW CORNELL AVE
LAWTON OK
73505-7121
US

IV. Provider business mailing address

3401 W GORE BLVD
LAWTON OK
73505-6300
US

V. Phone/Fax

Practice location:
  • Phone: 580-248-0696
  • Fax: 580-357-7589
Mailing address:
  • Phone: 580-355-8620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number16952
License Number StateOK

VIII. Authorized Official

Name: BRENT SMITH
Title or Position: CFO
Credential:
Phone: 580-355-8620