Organization
BLACKHAWK MANGUM LLC
Active
Other names
Quartz Mountain Medical Clinic Mangum North
Organization subpart
No
Provider details
NPI number
Authorized official
JAN WINTER (CEO)
(580) 782-3353
Entity
Organization
Contact information
Practice address
ONE WICKERSHAM DRIVE, MANGUM, OK 73554-9117
(580) 782-3353
Mailing address
PO BOX 280, MANGUM, OK 73554-0280
(580) 782-3353
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2009
Last updated
09/25/2009
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