Provider Demographics
NPI:1699852764
Name:OKLAHOMA UNION PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:OKLAHOMA UNION PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-255-6550
Mailing Address - Street 1:RT 1 BOX 377-7
Mailing Address - Street 2:OKLAHOMA UNION PUBLIC SCHOOLS/ATTN MADONNA
Mailing Address - City:SOUTH COFFEYVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74072-9756
Mailing Address - Country:US
Mailing Address - Phone:918-255-6552
Mailing Address - Fax:918-255-6817
Practice Address - Street 1:OKLAHOMA UNION PUBLIC SCHOOLS ATTN MADONNA
Practice Address - Street 2:RT 1 BOX 377-7
Practice Address - City:SOUTH COFFEYVILLE
Practice Address - State:OK
Practice Address - Zip Code:74072-9756
Practice Address - Country:US
Practice Address - Phone:918-255-6552
Practice Address - Fax:918-255-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK100684150A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty