MEDICARE: SCHOOL DISTRICT OF FORT ATKINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720251218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT OF FORT ATKINSON

Provider Business Mailing Address
First Line	:	201 PARK ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-2155
Country	:	US
Telephone Number	:	920-563-7807
Fax Number	:	920-563-7809

Provider Business Practice Location Address
First Line	:	201 PARK ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-2155
Country	:	US
Telephone Number	:	920-563-7807
Fax Number	:	920-563-7809

Authorized Official
Title or Position	:	DISTRICT ADMINISTRATOR
Name	:	DR. JAMES FITZPATRICK
Credential	:
Telephone Number	:	920-563-7807

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	04/07/2008

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