Healthcare Provider Details

I. General information

NPI: 1578520672
Provider Name (Legal Business Name): BEN HURST FREEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6144 AIRPORT BLVD
MOBILE AL
36608-3143
US

IV. Provider business mailing address

PO BOX 86144
MOBILE AL
36689-6144
US

V. Phone/Fax

Practice location:
  • Phone: 251-476-5050
  • Fax: 251-450-2770
Mailing address:
  • Phone: 251-476-5050
  • Fax: 251-450-2770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number00012113
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: