BLACKHAWK MANGUM LLC NPI 1093247082

NPI Information

NPI: 1093247082
Provider Name: BLACKHAWK MANGUM, LLC

Doing Business As: ALTUS RADIOLOGY CENTER

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
1 WICKERSHAM ST
MANGUM, OK
ZIP 73554
Phone: (580) 782-3353
Get Directions

BLACKHAWK MANGUM, LLC is a radiology clinic center in Mangum, OK. BLACKHAWK MANGUM, LLC NPI is 1093247082. The provider is registered as an organization entity type.
The provider Is Doing Business As Altus Radiology Center.

The provider's business location address is:

1 WICKERSHAM ST
MANGUM, OK
ZIP 73554-117
Phone: (580) 782-3353
Fax: (580) 782-5944

The provider's authorized official is Tommy Johnson .
The authorized official title is Ceo and has the following contact phone number (580) 782-3353.

The enumeration date for this NPI number is 3/30/2017 and was last updated on 3/30/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology	2208	OKLAHOMA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »