Provider Demographics
NPI:1982976742
Name:RICHARD ZIELINSKI MD, PLLC
Entity Type:Organization
Organization Name:RICHARD ZIELINSKI MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:405-788-8883
Mailing Address - Street 1:712 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WATONGA
Mailing Address - State:OK
Mailing Address - Zip Code:73772
Mailing Address - Country:US
Mailing Address - Phone:405-788-8883
Mailing Address - Fax:
Practice Address - Street 1:712 W 3RD ST
Practice Address - Street 2:
Practice Address - City:WATONGA
Practice Address - State:OK
Practice Address - Zip Code:73772
Practice Address - Country:US
Practice Address - Phone:405-788-8883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK187952084P0800X, 2084P0802X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty