BLACKHAWK MANGUM, LLC – Family Medicine Physician, NPI 1093986937

BLACKHAWK MANGUM, LLC is a healthcare provider. based in Mangum, Oklahoma. specializing in Family Medicine Physician. The organization holds a License No. 2208 (OK). The NPI Number for BLACKHAWK MANGUM, LLC is 1093986937

Main info

Organization
Name
BLACKHAWK MANGUM, LLC
NPI
1093986937
Phone
Not provided
Address
PO BOX 280
Authorized Official
SHANA DAVENPORT INSURANCE CREDENTIALING SUPERVISOR
Enumeration Date
19 March 2008
Last Update Date
23 July 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for BLACKHAWK MANGUM, LLC

  • PO BOX 280

    MANGUM, OK 73554

    Phone:

    Type: Mailing

  • Wickersham Drive, Mangum, Greer County, Oklahoma, 73554, United States

    MANGUM, OK 73554

    Phone: (580) 782-3353

    Fax: (580) 782-2811

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73554)

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Reviews

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Frequently asked questions

Does BLACKHAWK MANGUM, LLC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BLACKHAWK MANGUM, LLC uses 1093986937.
Does CMS list BLACKHAWK MANGUM, LLC as active?
Yes — BLACKHAWK MANGUM, LLC is active in the NPI listing used on this page.
What taxonomy line describes BLACKHAWK MANGUM, LLC?
For research purposes, treat BLACKHAWK MANGUM, LLC as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is BLACKHAWK MANGUM, LLC based?
BLACKHAWK MANGUM, LLC is tied to Mangum, Oklahoma in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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