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General NPI Number Information
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NPI Number | 1134243991
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Entity Type | Organization
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Legal Business Name | PEAVINE SCHOOL DISTRICT
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | ROUTE 3, HIGHWAY 59 NORTH
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City | STILWELL
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State | OK
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Zip | 74960
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Country | US
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Telephone | 918-696-7818
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Fax |
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Provider Business Mailing Address
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Address Line | ROUTE 3 P.O. BOX 389
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City | STILWELL
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State | OK
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Zip | 74960
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Country | US
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Telephone | 918-696-7818
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. MICHAEL WOLFE
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Credential |
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Telephone | 918-696-7818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 251K00000X
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License Number State | OK
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