Manda Lea Stephens (NPI# 1831471101, PAC ID# 3274706726) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1831471101 |
| PAC ID by PECOS | 3274706726 |
| Professional Enrollment ID | I20111227000311 |
| Full Name | Manda Lea Stephens |
| Organization Legal Name | BLACKHAWK MANGUM LLC |
| Address |
3000 N Main St Quartz Mtn Med Ctr Altus OK 73521-1348 |
| Phone Number | 5807823353 |
| Gender | F |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2365477635 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 371330 | QUARTZ MOUNTAIN MEDICAL CENTER |
| 370022 | JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY |
| Address | Phone | Organization |
|---|---|---|
| 3000 N Main St, Quartz Mtn Med Ctr, Altus, OK 73521-1348 | 5807823353 | BLACKHAWK MANGUM LLC |
| 3000 N Main St, Altus, OK 73521-1348 | 5807823353 | BLACKHAWK MANGUM LLC |
| Organization Legal Name | BLACKHAWK MANGUM LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Zachary | Nurse Practitioner | Blackhawk Mangum LLC | 1 Wickersham St, Mangum, OK 73554-9117 |
| Edwinna G Smith | Nurse Practitioner | Blackhawk Mangum LLC | 1 Wickersham St, Mangum, OK 73554-9117 |
| James L Johnson | Family Practice | Blackhawk Mangum LLC | 1 Wickersham St, Mangum, OK 73554-9117 |
| Street Address |
3000 N MAIN ST QUARTZ MTN MED CTR |
| City | ALTUS |
| State | OK |
| Zip | 73521-1348 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pauline Mary Raasch | Physical Therapy | Orthopedic and Sports Medicine Center of Northern Indiana, Inc. | 3000 N Main St, Nappanee, IN 46550-8975 |
| Michelle R Martin | Physical Therapy | Orthopedic and Sports Medicine Center of Northern Indiana, Inc. | 3000 N Main St, Nappanee, IN 46550-8975 |
| Kamran M Massoumi | Ophthalmology | Oklahoma Eye Institute | 3000 N Main St, Altus, OK 73521-1348 |
| Cole W Wootton | Urology | Western Oklahoma Urology Pllc | 3000 N Main St, Altus, OK 73521-1348 |
| Michele R Kyser Lafree | Occupational Therapy | Orthopedic and Sports Medicine Center of Northern Indiana, Inc. | 3000 N Main St, Nappanee, IN 46550-8975 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amie R Straub | Optometry | 112 Val Verde St, Suite C, Altus, OK 73521-1190 | |
| Steven Arthur Gifford | Optometry | Altus Family Vision Pllc | 112 Val Verde St, Suite C, Altus, OK 73521-1190 |
| Bryce Jacob Geiger | Optometry | Michael W. Geiger, Od PC | 809 E Tamarack Rd, Altus, OK 73521-1231 |
| Seth H Geiger | Optometry | Michael W. Geiger, Od PC | 809 E Tamarack Rd, Altus, OK 73521-1231 |
| Michael W Geiger | Optometry | Michael W. Geiger, Od PC | 809 E Tamarack Rd, Altus, OK 73521-1231 |
| John Ryan Gallagher | Orthopedic Surgery | Ryan Gallagher Pllc | 3216 N Main St, Altus, OK 73521-1307 |
| Monte D Combs | Nurse Practitioner | Ryan Gallagher Pllc | 3216 N Main St, Altus, OK 73521-1307 |
| David Major Huey | Optometry | 1425 N Main St, Altus, OK 73521-2101 | |
| Carl B Reed | Chiropractic | 1311 N Main St B, Altus, OK 73521-3125 | |
| Juan R Villazon | Neurology | 219 E Commerce St, Altus, OK 73521-3913 | |
| Find all physicians in zip 73521 | |||
| City | ALTUS |
| Zip Code | 73521 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ALTUS + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Manda Lea Stephens.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.