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ALTUS RADIOLOGY CENTER
NPI 1093247082
Clinic/Center - Radiology in Mangum, OK

Active since March 30, 2017
1 WICKERSHAM ST, MANGUM, OK 73554(580) 782-3353(580) 782-5944 Get Directions Write a Review

NPPES record last updated: March 30, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Altus Radiology Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALTUS RADIOLOGY CENTER (NPI 1093247082) is a healthcare organization registered as a radiology in Mangum, Oklahoma and active in the NPI registry since March 2017. The organization lists Tommy Johnson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093247082
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameBLACKHAWK MANGUM, LLC
Location Address1 WICKERSHAM STMangum, OK 73554-9117
Mailing Address3000 N Main St, Suite 100Altus, OK 73521-1348 · (580) 477-2674 · Fax (580) 477-2598
Phone(580) 782-3353
Fax(580) 782-5944
Organization SubpartYes
Authorized OfficialTommy JohnsonCeo · (580) 782-3353
Enumeration DateMarch 30, 2017
✔ NPI 1093247082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
License✔ Licensed in OK · 2208
1 WICKERSHAM ST, Mangum, OK 73554
Open in Google Maps ↗

Other Names 1

Doing Business AsAltus Radiology Center

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUSSELL D BERRY LPTA
Physical Therapy Assistant
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
BLACKHAWK MANGUM, LLC
Clinic/Center
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
BLACKHAWK MANGUM, LLC
Clinic/Center
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
MANGUM CITY HOSPITAL AUTHORITY
General Acute Care Hospital (Critical Access)
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
MANGUM CITY HOSPITAL AUTHORITY
Medicare Defined Swing Bed Unit
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
NELSON SIMBA OGEMBO FNP-C
Nurse Practitioner (Family)
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
MR. JEFFREY ALLEN BRAND PA-C
Physician Assistant (Medical)
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353
CHRISTIAN SMITH
Physical Therapist
1 WICKERSHAM ST
MANGUM, OK 73554
Greer County (580) 782-3353

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blackhawk Mangum, LLC's NPI number?

The NPI number for Blackhawk Mangum, LLC is 1093247082. It was assigned to this organization in the NPPES registry on March 30, 2017. The provider is doing business as Altus Radiology Center.

Where is Blackhawk Mangum, LLC located?

Blackhawk Mangum, LLC is located at 1 Wickersham St, Mangum, OK 73554. The listed phone number is (580) 782-3353.

What is Blackhawk Mangum, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

When was this NPI record last updated?

The NPPES record for Blackhawk Mangum, LLC was last updated on March 30, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.