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General NPI Number Information
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NPI Number | 1881107365
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Entity Type | Organization
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Legal Business Name | GEROPSYCH MANAGEMENT, LLC
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/07/2017
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Provider Practice Location Address
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Address Line | 2942 N 24TH ST STE 114
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City | PHOENIX
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State | AZ
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Zip | 85016-7849
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Country | US
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Telephone | 405-417-4666
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 RICHMOND SQ STE 102
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-2042
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Country | US
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Telephone | 405-840-1999
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Fax | 405-848-3298
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Authorized Official
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Title or Position | OWNER
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Name | DAVID E LINDEN
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Credential | MD
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Telephone | 405-840-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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