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General NPI Number Information
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NPI Number | 1194122994
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Entity Type | Organization
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Legal Business Name | OAK GROVE ELEMENTARY SCHOOL
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 70 LEAF LN
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City | HATTIESBURG
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State | MS
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Zip | 39402-9549
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Country | US
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Telephone | 601-264-9764
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Fax |
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Provider Business Mailing Address
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Address Line | 424 MARTIN LUTHER KING DR
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City | PURVIS
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State | MS
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Zip | 39475-5028
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Country | US
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Telephone | 601-794-1030
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT OF EDUCATION
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Name | DR. STEVEN HAMPTON
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Credential |
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Telephone | 601-794-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | R888519
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 876971
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License Number State | MS
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