Healthcare Provider Details

I. General information

NPI: 1730369968
Provider Name (Legal Business Name): PREFERRED FOOTCARE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 N 16TH ST
NEW CASTLE IN
47362-4320
US

IV. Provider business mailing address

PO BOX 247
ALBANY IN
47320-0247
US

V. Phone/Fax

Practice location:
  • Phone: 765-284-4220
  • Fax: 765-284-5254
Mailing address:
  • Phone: 765-284-4220
  • Fax: 765-284-5254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07000587
License Number StateIN

VIII. Authorized Official

Name: DR. THOMAS EDWARD FREEMAN II
Title or Position: PHYSICIAN OWNER
Credential: DPM
Phone: 765-284-4220