Blackhawk Mangum, LLC
Blackhawk Mangum, LLC is an Emergency Medicine Physician in Mangum, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2008.
- Licensed in
- OK
- In the registry since
- 2008
- Specialties on file
- 4
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Partly verified
One Wickersham DrMangum, OK 73554
Phone: (580) 782-3353
Fax: (580) 782-2811
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 2208 (OK) |
|---|---|
| Emergency Medicine Physician | Taxonomy 207P00000X · Licence 2208 (OK) |
| Physician Assistant | Taxonomy 363A00000X · Licence 2208 (OK) |
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 2208 (OK) |
Record details
| NPI number | 1093986937 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shana Davenport — Insurance Credentialing Supervisor · (512) 681-3460 |
| NPI enumerated | March 19, 2008 |
| Last updated in NPPES | July 23, 2008 |
| Mailing address | Po Box 280, Mangum, OK 73554 |