Provider Demographics
NPI:1417093923
Name:LINHARDT, RICHARD (MED)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:LINHARDT
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N. CLASSEN BLVD.
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106
Mailing Address - Country:US
Mailing Address - Phone:405-524-0969
Mailing Address - Fax:405-523-3015
Practice Address - Street 1:1501 N. CLASSEN BLVD.
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106
Practice Address - Country:US
Practice Address - Phone:405-524-0969
Practice Address - Fax:405-523-3015
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist