Provider Demographics
NPI:1376667410
Name:IZARD COUNTY CONSOLIDATED SCHOOLS
Entity Type:Organization
Organization Name:IZARD COUNTY CONSOLIDATED SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-258-7700
Mailing Address - Street 1:HWY. 9 NORTH
Mailing Address - Street 2:
Mailing Address - City:BROCKWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HWY 9 N
Practice Address - Street 2:
Practice Address - City:BROCKWELL
Practice Address - State:AR
Practice Address - Zip Code:72517-0115
Practice Address - Country:US
Practice Address - Phone:870-258-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116973743Medicaid
AR116973742Medicaid