=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205979887
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORGAN COUNTY BOARD OF EDUCATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 PRESTONSBURG STREET
-----------------------------------------------------
City | WEST LIBERTY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-743-8002
-----------------------------------------------------
Fax | 606-743-8050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 460 PRESTONSBURG STREET
-----------------------------------------------------
City | WEST LIBERTY
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-743-8002
-----------------------------------------------------
Fax | 606-743-8050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERINTENDENT
-----------------------------------------------------
Name | MR. JOE DAN GOLD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 606-743-8002
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | 21088018
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------