Provider Demographics
NPI:1184762882
Name:WILLIAMSBURG INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:WILLIAMSBURG INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-549-6044
Mailing Address - Street 1:1000 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-1028
Mailing Address - Country:US
Mailing Address - Phone:606-549-6044
Mailing Address - Fax:606-549-6076
Practice Address - Street 1:1000 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1028
Practice Address - Country:US
Practice Address - Phone:606-549-6044
Practice Address - Fax:606-549-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21118039Medicaid