Healthcare Provider Details

I. General information

NPI: 1578656419
Provider Name (Legal Business Name): MADILL PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W MCARTHUR ST
MADILL OK
73446-2846
US

IV. Provider business mailing address

601 W MCARTHUR ST
MADILL OK
73446-2846
US

V. Phone/Fax

Practice location:
  • Phone: 580-795-3303
  • Fax: 580-795-3210
Mailing address:
  • Phone: 580-795-3303
  • Fax: 580-795-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number100687680A
License Number StateOK

VIII. Authorized Official

Name: MR. JON DOTSON
Title or Position: SUPERINTENDENT
Credential:
Phone: 580-795-3303