Healthcare Provider Details

I. General information

NPI: 1104862986
Provider Name (Legal Business Name): JAMES G. FREEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 06/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MADISON AVE 3RD FLOOR
ELMIRA NY
14901-3218
US

IV. Provider business mailing address

571 SAINT JOSEPHS BLVD FL 2
ELMIRA NY
14901-3230
US

V. Phone/Fax

Practice location:
  • Phone: 607-734-1581
  • Fax: 607-734-0972
Mailing address:
  • Phone: 607-271-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number170165
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number170165
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: