Provider Demographics
NPI:1225065006
Name:ZIELINSKI, RICHARD FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FREDERICK
Last Name:ZIELINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SANDY AVE
Mailing Address - Street 2:
Mailing Address - City:WATONGA
Mailing Address - State:OK
Mailing Address - Zip Code:73772-7216
Mailing Address - Country:US
Mailing Address - Phone:405-695-3134
Mailing Address - Fax:580-623-4212
Practice Address - Street 1:201 SANDY AVE
Practice Address - Street 2:
Practice Address - City:WATONGA
Practice Address - State:OK
Practice Address - Zip Code:73772-7216
Practice Address - Country:US
Practice Address - Phone:405-695-3134
Practice Address - Fax:580-623-4212
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18795103TP0016X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100230910 AMedicaid
OK8005222311Medicare PIN