Healthcare Provider Details

I. General information

NPI: 1073643805
Provider Name (Legal Business Name): MOUNTAINBURG PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 HIGHWAY 71 SW
MOUNTAINBURG AR
72946-4112
US

IV. Provider business mailing address

129 HIGHWAY 71 SW
MOUNTAINBURG AR
72946-4112
US

V. Phone/Fax

Practice location:
  • Phone: 479-369-2121
  • Fax: 479-369-2138
Mailing address:
  • Phone: 479-369-2121
  • Fax: 479-369-2138

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: MR. DENNIS COPELAND
Title or Position: SUPERINTENDENT
Credential:
Phone: 479-369-2121