1144339706 NPI number — JOHN J. FREEMAN, MD, PA

Table of content: (NPI 1144339706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144339706 NPI number — JOHN J. FREEMAN, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN J. FREEMAN, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144339706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 WAMSUTTA MILL RD
Provider Second Line Business Mailing Address:
SU: B
Provider Business Mailing Address City Name:
MORGANTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28655-5522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-430-3511
Provider Business Mailing Address Fax Number:
828-430-3513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
838 STATE FARM RD.
Provider Second Line Business Practice Location Address:
SU: 2
Provider Business Practice Location Address City Name:
BOONE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28607-5391
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-264-1282
Provider Business Practice Location Address Fax Number:
828-430-3513
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FREEMAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
828-430-3511

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  18948 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208D00000X , with the licence number: 18948 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33820 . This is a "NC BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 4173162 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8933820 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com