| Blackhawk Mangum, Llc | |
|
118 South Louis Tittle Mangum OK 73554 | |
| (580) 782-2113 | |
| (580) 782-2141 |
| Full Name | Blackhawk Mangum, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 118 South Louis Tittle, Mangum, 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 118 South Louis Tittle Mangum OK 73554 Ph: (580) 782-2113 |
| NPI Number | 1033388509 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 03/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033388509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2208 (Oklahoma) | Primary |
Jackson County Memorial Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 114 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-3393 Fax: 580-782-3395 | |
Blackhawk Mangum Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: One Wickersham Drive, Mangum, OK 73554 Phone: 580-782-3353 | |
Blackhawk Mangum Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-3353 | |
Blackhawk Mangum, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Wickersham St, Mangum, OK 73554 Phone: 580-782-3353 | |
Mangum City Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 118 S Louis Tittle Ave, Mangum, OK 73554 Phone: 580-782-2000 Fax: 580-782-5906 | |
Tlc Of Chiropractic L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 W Lincoln St, Mangum, OK 73554 Phone: 580-782-3141 |