Healthcare Provider Details

I. General information

NPI: 1144339706
Provider Name (Legal Business Name): JOHN J. FREEMAN, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 STATE FARM RD. SU: 2
BOONE NC
28607-5391
US

IV. Provider business mailing address

125 WAMSUTTA MILL RD SU: B
MORGANTON NC
28655-5522
US

V. Phone/Fax

Practice location:
  • Phone: 828-264-1282
  • Fax: 828-430-3513
Mailing address:
  • Phone: 828-430-3511
  • Fax: 828-430-3513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18948
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number18948
License Number StateNC

VIII. Authorized Official

Name: JOHN J. FREEMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 828-430-3511