Provider Demographics
NPI:1356424865
Name:KINGSTON PUBLIC SCHOOL
Entity type:Organization
Organization Name:KINGSTON PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-564-9033
Mailing Address - Street 1:400 NE 3D STREET
Mailing Address - Street 2:PO BOX 370
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439-0370
Mailing Address - Country:US
Mailing Address - Phone:580-564-9033
Mailing Address - Fax:580-564-9516
Practice Address - Street 1:400 NE 3D STREET
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OK
Practice Address - Zip Code:73439-0370
Practice Address - Country:US
Practice Address - Phone:580-564-9033
Practice Address - Fax:580-564-9516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251K00000X305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization