Provider Demographics
NPI:1528299435
Name:CANTON PUBLIC SCHOOL DISTRICT
Entity type:Organization
Organization Name:CANTON PUBLIC SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUCKETT
Authorized Official - Suffix:SR
Authorized Official - Credentials:EDS
Authorized Official - Phone:601-859-4110
Mailing Address - Street 1:403 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-3215
Mailing Address - Country:US
Mailing Address - Phone:601-859-4110
Mailing Address - Fax:601-859-4023
Practice Address - Street 1:403 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-3215
Practice Address - Country:US
Practice Address - Phone:601-859-4110
Practice Address - Fax:601-859-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service