Healthcare Provider Details

I. General information

NPI: 1821435108
Provider Name (Legal Business Name): DECATUR PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 STADIUM AVE
DECATUR AR
72722-9780
US

IV. Provider business mailing address

1498 STADIUM AVE
DECATUR AR
72722-9780
US

V. Phone/Fax

Practice location:
  • Phone: 479-736-2253
  • Fax: 479-736-5682
Mailing address:
  • Phone: 479-736-2253
  • Fax: 479-736-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDY BARRETT
Title or Position: SUPERINTENDENT
Credential:
Phone: 479-736-2253