Healthcare Provider Details

I. General information

NPI: 1174587976
Provider Name (Legal Business Name): HENRYETTA PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W TROY AIKMAN DR
HENRYETTA OK
74437-3851
US

IV. Provider business mailing address

1801 W TROY AIKMAN DR
HENRYETTA OK
74437-3851
US

V. Phone/Fax

Practice location:
  • Phone: 918-652-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: DWAYNE NOBLE
Title or Position: SUPERINTENDENT
Credential:
Phone: 918-652-6523