MEDICARE: DR. LINDA ANN HERSHEY MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	137749-1	NY

General Provider Information

NPI Number	:	1639102106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA ANN HERSHEY MD, PHD

Provider Business Mailing Address
First Line	:	711 STANTON YOUNG BLVD
Second Line	:	DEPT OF NEUROLOGY (SUITE 215)
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5021
Country	:	US
Telephone Number	:	405-271-4113
Fax Number	:	405-271-5723

Provider Business Practice Location Address
First Line	:	711 STANTON YOUNG BLVD
Second Line	:	DEPT OF NEUROLOGY (SUITE 215)
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5021
Country	:	US
Telephone Number	:	405-271-4113
Fax Number	:	405-271-5723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	05/24/2010

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