MEDICARE: JORDAN FREELAND DO

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	207Q00000X	Family Medicine Physician	4439	WV
2	207Q00000X	Family Medicine Physician	83578	SC

General Provider Information

NPI Number	:	1861075129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN FREELAND DO

Provider Business Mailing Address
First Line	:	155 ACADEMY AVE
Second Line	:
City	:	GREENWOOD
State	:	SC
Zip	:	29646-3869
Country	:	US
Telephone Number	:	864-725-4865
Fax Number	:

Provider Business Practice Location Address
First Line	:	3774 VALLEY RD
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-4614
Country	:	US
Telephone Number	:	304-258-9433
Fax Number	:	304-258-6063

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

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	01/28/2025

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