BLACKHAWK MANGUM LLC NPI 1225362015

NPI Information

  • NPI: 1225362015
  • Provider Name: BLACKHAWK MANGUM LLC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: QUARTZ MOUNTAIN MEDICAL CLINIC MANGUM NORTH
  • Address: ONE WICKERSHAM DRIVE
    MANGUM, OK
    ZIP 73554
  • Phone: (580) 782-3353

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NPI Details

BLACKHAWK MANGUM LLC is a rural health clinic center in Mangum, OK. BLACKHAWK MANGUM LLC NPI is 1225362015. The provider is registered as an organization entity type.
The provider Is Doing Business As Quartz Mountain Medical Clinic Mangum North.

The provider's business location address is:

ONE WICKERSHAM DRIVE
MANGUM, OK
ZIP 73554-117
Phone: (580) 782-3353

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

The enumeration date for this NPI number is 9/25/2009 and was last updated on 9/25/2009.

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
1261QR1300XClinic/CenterRural HealthYes

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: 11/21/2025

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