Healthcare Provider Details

I. General information

NPI: 1225065006
Provider Name (Legal Business Name): RICHARD FREDERICK ZIELINSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SANDY AVE
WATONGA OK
73772-7216
US

IV. Provider business mailing address

201 SANDY AVE
WATONGA OK
73772-7216
US

V. Phone/Fax

Practice location:
  • Phone: 405-695-3134
  • Fax: 580-623-4212
Mailing address:
  • Phone: 405-695-3134
  • Fax: 580-623-4212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number18795
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number18795
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: