Provider Demographics
NPI:1235482795
Name:LINHARDT, RONALD DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DEAN
Last Name:LINHARDT
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 1:1 TREELINE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4628
Mailing Address - Country:US
Mailing Address - Phone:636-240-9340
Mailing Address - Fax:
Practice Address - Street 1:1 TREELINE DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MO
Practice Address - Zip Code:63366-4628
Practice Address - Country:US
Practice Address - Phone:636-240-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-14033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
04-14033OtherKANSAS STATE BOARD OF HEALING ARTS