Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blackhawk Mangum, LLC

Organization Primary Care Clinic/Center · NPI 1366611824

Blackhawk Mangum, LLC is a Primary Care Clinic/Center in Hollis, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2008.

Licensed in
OK
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

513 E Chestnut
Hollis, OK 73550
Phone: (580) 688-3314
Fax: (580) 688-9530
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 2208 (OK)

Record details

NPI number1366611824
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shana Davenport — Insurance Credentialing Supervisor · (512) 681-3460
Other names Quartz Mountain Medical Center - Hollis
NPI enumeratedFebruary 28, 2008
Last updated in NPPESJuly 23, 2008
Mailing addressPo Box 280, Mangum, OK 73554-0280