Provider Demographics
NPI:1659566263
Name:CHOUTEAU-MAZIE
Entity Type:Organization
Organization Name:CHOUTEAU-MAZIE
Other - Org Name:CHOUTEAU-MAZIE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-476-8386
Mailing Address - Street 1:PO BOX 969
Mailing Address - Street 2:
Mailing Address - City:CHOUTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74337-0969
Mailing Address - Country:US
Mailing Address - Phone:918-476-8386
Mailing Address - Fax:
Practice Address - Street 1:201 N MCCRAKEN
Practice Address - Street 2:
Practice Address - City:CHOUTEAU
Practice Address - State:OK
Practice Address - Zip Code:74337-0969
Practice Address - Country:US
Practice Address - Phone:918-476-8386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)