Healthcare Provider Details

I. General information

NPI: 1417038811
Provider Name (Legal Business Name): CROWDER PUBLIC SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BOND ST. & E ST.
CROWDER OK
74430
US

IV. Provider business mailing address

PO BOX B BOND ST AND E ST.
CROWDER OK
74430
US

V. Phone/Fax

Practice location:
  • Phone: 918-334-3203
  • Fax: 918-334-3295
Mailing address:
  • Phone: 918-334-3203
  • Fax: 918-334-3295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateOK

VIII. Authorized Official

Name: MR. DAVID JONES
Title or Position: SUPERINTENDENT
Credential:
Phone: 918-334-3203