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General NPI Number Information
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NPI Number | 1558730168
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Entity Type | Organization
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Legal Business Name | SOUTHGATE INDEPENDENT SCHOOL DISTRICT
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 6 WILLIAM BLATT AVE
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City | SOUTHGATE
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State | KY
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Zip | 41701
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Country | US
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Telephone | 859-441-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 6 WM BLATT AVE
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City | SOUTHGATE
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State | KY
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Zip | 41071
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Country | US
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Telephone | 859-441-0743
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Fax | 859-441-6735
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. JAMES R. PALM
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Credential |
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Telephone | 859-441-0743
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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 | KY
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