Organization
SHADY POINT SCHOOLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE GILLHAM (SUPERINTENDENT)
(918) 963-2595
Entity
Organization
Contact information
Practice address
22838 WHEELUS STREET, SHADY POINT, OK 74956
(918) 963-2595
(918) 963-2605
Mailing address
P.O. BOX 1005, SHADY POINT, OK 74956
(918) 963-2595
(918) 963-2605
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100681090A
—
OK
Enumeration date
09/25/2006
Last updated
11/11/2010
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