Healthcare Provider Details

I. General information

NPI: 1366743148
Provider Name (Legal Business Name): PATRICK FRANCIS FREEMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 PEORIA ST #190
AURORA CO
80010-1483
US

IV. Provider business mailing address

3350 PEORIA ST #190
AURORA CO
80010-1483
US

V. Phone/Fax

Practice location:
  • Phone: 303-340-3053
  • Fax:
Mailing address:
  • Phone: 303-340-3053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3124
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: