| Blackhawk Mangum, Llc | |
|
513 East Chestnut Hollis OK 73550 | |
| (580) 688-3314 | |
| (580) 688-9530 |
| Full Name | Blackhawk Mangum, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 513 East Chestnut, Hollis, Oklahoma |
| Authorized Official Name and Position | Shana Davenport (INSURANCE CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 5126813460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackhawk Mangum, Llc Po Box 280 Mangum OK 73554-0280 Ph: () - | Blackhawk Mangum, Llc 513 East Chestnut Hollis OK 73550 Ph: (580) 688-3314 |
| NPI Number | 1366611824 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 07/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366611824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2208 (Oklahoma) | Primary |
Akram R. Abraham, M.d.pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 920 N 8th St, Hollis, OK 73550 Phone: 580-688-2200 Fax: 580-688-2229 | |
Shortgrass Community Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 E Sycamore St, Hollis, OK 73550 Phone: 580-688-2800 Fax: 580-688-2193 | |
Schafer Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 E Chestnut St, Hollis, OK 73550 Phone: 580-688-3314 Fax: 580-688-9530 | |
Harmon County Healthcare Authority Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 E Chestnut St, Hollis, OK 73550 Phone: 580-688-2800 Fax: 580-688-2193 | |
Richard W. Schafer, D.o., Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 E Chestnut St, Hollis, OK 73550 Phone: 580-688-3314 Fax: 580-688-9530 |