Provider Demographics
NPI:1598509234
Name:HENDRICKS, LINDEN A
Entity type:Individual
Prefix:MR
First Name:LINDEN
Middle Name:A
Last Name:HENDRICKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-3341
Mailing Address - Country:US
Mailing Address - Phone:405-831-8388
Mailing Address - Fax:
Practice Address - Street 1:3817 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-3341
Practice Address - Country:US
Practice Address - Phone:405-831-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program