Provider Demographics
NPI:1609092709
Name:DUSTIN PUBLIC SCHOOL
Entity Type:Organization
Organization Name:DUSTIN PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-656-3211
Mailing Address - Street 1:203 WISDOM AVENUE
Mailing Address - Street 2:P. O. BOX 390660
Mailing Address - City:DUSTIN
Mailing Address - State:OK
Mailing Address - Zip Code:74837-0660
Mailing Address - Country:US
Mailing Address - Phone:918-656-3211
Mailing Address - Fax:918-656-3242
Practice Address - Street 1:203 WISDOM AVENUE
Practice Address - Street 2:
Practice Address - City:DUSTIN
Practice Address - State:OK
Practice Address - Zip Code:74839-0660
Practice Address - Country:US
Practice Address - Phone:918-656-3211
Practice Address - Fax:918-656-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)