Provider Demographics
NPI:1730548322
Name:STILWELL PUBLIC SCHOOLS
Entity type:Organization
Organization Name:STILWELL PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARPROFFESIONAL
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:ESSARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-696-6989
Mailing Address - Street 1:1801 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-3259
Mailing Address - Country:US
Mailing Address - Phone:918-696-7276
Mailing Address - Fax:
Practice Address - Street 1:1801 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3259
Practice Address - Country:US
Practice Address - Phone:918-696-7276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty