Healthcare Provider Details

I. General information

NPI: 1255363313
Provider Name (Legal Business Name): SOUTHWEST ANESTHESIA - SERVICE OF COMANCHE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 W GORE BLVD
LAWTON OK
73505-6332
US

IV. Provider business mailing address

3401 W GORE BLVD
LAWTON OK
73505-6332
US

V. Phone/Fax

Practice location:
  • Phone: 580-355-8620
  • Fax: 580-357-3277
Mailing address:
  • Phone: 580-355-8620
  • Fax: 580-357-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: TOM STEINMETZ
Title or Position: DIVISION DIRECTOR
Credential:
Phone: 580-355-8620