Blackhawk Mangum, LLC
NPI 1093986937 · Family Medicine Physician · Mangum, OK
Blackhawk Mangum, LLC is a Family Medicine Physician organization in Mangum, OK (NPI 1093986937).
Provider details
- NPI number
- 1093986937
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shana Davenport, Insurance Credentialing Supervisor(512) 681-3460
- License
- 2208 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Mailing address
Registry dates
- Enumerated
- 2008-03-19
- Last updated
- 2008-07-23
Frequently asked questions
- What is Blackhawk Mangum, LLC's NPI number?
- Blackhawk Mangum, LLC's National Provider Identifier (NPI) is 1093986937, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blackhawk Mangum, LLC?
- Blackhawk Mangum, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Blackhawk Mangum, LLC located?
- Blackhawk Mangum, LLC's practice location on file with NPPES is One Wickersham Dr, Mangum, OK 73554.
- What is Blackhawk Mangum, LLC's phone number?
- The practice phone number listed in the NPPES registry for Blackhawk Mangum, LLC is (580) 782-3353.
- Who is the authorized official for Blackhawk Mangum, LLC?
- The authorized official listed on Blackhawk Mangum, LLC's NPPES record is Shana Davenport, Insurance Credentialing Supervisor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blackhawk Mangum, LLC's NPI active?
- Yes — Blackhawk Mangum, LLC's NPI (1093986937) is active in the NPPES registry as of the last update on 2008-07-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.