Healthcare Provider Details
I. General information
NPI: 1396747648
Provider Name (Legal Business Name): WILLIAM H. FREEMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/01/2005
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 CLUB LN
CONWAY AR
72034-3624
US
IV. Provider business mailing address
600 CLUB LN
CONWAY AR
72034-3624
US
V. Phone/Fax
- Phone: 501-327-0110
- Fax: 501-327-0141
- Phone: 501-327-0110
- Fax: 501-327-0141
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | C6022 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: