1407205859 NPI number — DR. SYDNIE CHRISTINE FREEMAN AU.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407205859 NPI number — DR. SYDNIE CHRISTINE FREEMAN AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREEMAN
Provider First Name:
SYDNIE
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

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:
1407205859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 N POINT PKWY
Provider Second Line Business Mailing Address:
STE 130
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30005-5210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-206-2589
Provider Business Mailing Address Fax Number:
678-261-1713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 NORTHSIDE FORSYTH DR
Provider Second Line Business Practice Location Address:
STE 490
Provider Business Practice Location Address City Name:
CUMMING
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30041-6012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-746-5920
Provider Business Practice Location Address Fax Number:
678-746-5929
Provider Enumeration Date:
06/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  1167A , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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