MEDICARE: INSIGHT SCHOOL OF OKLAHOMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1457109076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT SCHOOL OF OKLAHOMA

Provider Business Mailing Address
First Line	:	1117 S DOUGLAS BLVD STE E
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-455-8563
Fax Number	:	405-259-8332

Provider Business Practice Location Address
First Line	:	1117 S DOUGLAS BLVD STE E
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-455-8563
Fax Number	:	405-259-8332

Authorized Official
Title or Position	:	SR. MANAGER, SPECIAL PROGRAMS
Name	:	KATHERINE YOUNG
Credential	:
Telephone Number	:	405-455-8563

Provider Enumeration Date	:	05/08/2024
Last Update Date	:	05/08/2024

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