Healthcare Provider Details

I. General information

NPI: 1063577807
Provider Name (Legal Business Name): PERKINS TRYON PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SOUTHWEST 2ND STREET
PERKINS OK
74059-0549
US

IV. Provider business mailing address

PO BOX 549 103 SOUTHWEST 2ND STREET
PERKINS OK
74059-0549
US

V. Phone/Fax

Practice location:
  • Phone: 405-547-5703
  • Fax: 405-547-2020
Mailing address:
  • Phone: 405-547-5703
  • Fax: 405-547-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. MILTON JOSEPH DAVIS
Title or Position: MEDICAID DIRECTOR
Credential:
Phone: 405-547-5703