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Blackhawk Mangum, LLC

Family Medicine Physician in Mangum, OK · enumerated 2008 · authorized official Shana Davenport, Insurance Credentialing Supervisor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093986937

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Registry record

Entity type Organization (Type 2)
Legal business name Blackhawk Mangum, LLC
Practice address One Wickersham Dr, Mangum, OK, 73554
Phone (580) 782-3353
Fax (580) 782-2811
Enumeration date Mar 19, 2008
Last updated in NPPES Jul 23, 2008

Taxonomy & classification

207P00000X Emergency Medicine Physician Allopathic & Osteopathic Physicians · License 2208 (OK) Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 2208 (OK) Primary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 2208 (OK) Secondary
363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 2208 (OK) Secondary

Authorized official

Name Shana Davenport
Title Insurance Credentialing Supervisor
Phone (512) 681-3460

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Blackhawk Mangum, LLC?
Blackhawk Mangum, LLC is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-07-23.