Healthcare Provider Details

I. General information

NPI: 1538283106
Provider Name (Legal Business Name): LINDSEY M FREEMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY M FREEMAN

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 E 41ST ST 2ND FLOOR, STE A
TULSA OK
74135-2527
US

IV. Provider business mailing address

PO BOX 268838 SUITE 103
OKLAHOMA CITY OK
73126-8838
US

V. Phone/Fax

Practice location:
  • Phone: 918-619-4400
  • Fax: 918-619-4334
Mailing address:
  • Phone: 918-660-3632
  • Fax: 918-660-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1590
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: