MEDICARE: MULDROW PUBLIC SCHOOL

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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1902860471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULDROW PUBLIC SCHOOL

Provider Business Mailing Address
First Line	:	PO BOX 660
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-0660
Country	:	US
Telephone Number	:	918-427-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 WEST SHAWNTEL SMITH BLVD.
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-0660
Country	:	US
Telephone Number	:	918-427-7406
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. ROGER SHARP
Credential	:
Telephone Number	:	918-427-7406

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	08/22/2020

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Directions to “MULDROW PUBLIC SCHOOL ” Practice Location

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