Healthcare Provider Details

I. General information

NPI: 1881693497
Provider Name (Legal Business Name): CHRISTIAN FREUND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 S 6TH ST SUITE B
LEESVILLE LA
71446-4442
US

IV. Provider business mailing address

7100 COMMERCE WAY SUITE 180
BRENTWOOD TN
37027-2829
US

V. Phone/Fax

Practice location:
  • Phone: 337-238-1112
  • Fax:
Mailing address:
  • Phone: 615-465-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number15727R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: