OrganizationActive
Blackhawk Mangum, LLC
NPI 1093247082 · Radiology Clinic/Center · Mangum, OK
Provider details
- NPI number
- 1093247082
- Entity type
- Organization
- Primary specialty
- Radiology Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Blackhawk Mangum, LLC
- Organization subpart
- Yes
- Authorized official
- Tommy Johnson, Ceo(580) 782-3353
- License
- 2208 (OK)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1 Wickersham St
Mangum, OK 73554-9117
Phone: (580) 782-3353
Fax: (580) 782-5944
Street-level locationGet directions
Mailing address
3000 N Main St
Altus, OK 73521-1348
Other names (DBA / former)
- Doing business as
- Altus Radiology Center
Registry dates
- Enumerated
- 2017-03-30
- Last updated
- 2017-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.