Provider Demographics
NPI:1376616052
Name:MOFFETT PUBLIC SCHOOL
Entity Type:Organization
Organization Name:MOFFETT PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-875-3668
Mailing Address - Street 1:701 BELT AVE.
Mailing Address - Street 2:P.O. BOX 180
Mailing Address - City:MOFFETT
Mailing Address - State:OK
Mailing Address - Zip Code:74946-0180
Mailing Address - Country:US
Mailing Address - Phone:918-875-3668
Mailing Address - Fax:918-875-3201
Practice Address - Street 1:701 BELT AVE.
Practice Address - Street 2:
Practice Address - City:MOFFETT
Practice Address - State:OK
Practice Address - Zip Code:74946-0180
Practice Address - Country:US
Practice Address - Phone:918-875-3668
Practice Address - Fax:918-875-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)