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General NPI Number Information
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NPI Number | 1376616052
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Entity Type | Organization
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Legal Business Name | MOFFETT PUBLIC SCHOOL
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 BELT AVE.
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City | MOFFETT
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State | OK
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Zip | 74946-0180
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Country | US
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Telephone | 918-875-3668
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Fax | 918-875-3201
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Provider Business Mailing Address
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Address Line | 701 BELT AVE. P.O. BOX 180
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City | MOFFETT
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State | OK
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Zip | 74946-0180
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Country | US
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Telephone | 918-875-3668
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Fax | 918-875-3201
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. JOHN D. GORDON
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Credential |
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Telephone | 918-875-3668
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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 |
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License Number State |
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