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General NPI Number Information
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NPI Number | 1124194568
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Entity Type | Organization
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Legal Business Name | GEORGE EDWARD FREEMAN, D.O.,P.C.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 1425 E LINCOLN RD SUITE B-1
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City | IDABEL
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State | OK
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Zip | 74745-7345
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Country | US
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Telephone | 580-286-4949
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Fax | 580-286-4946
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Provider Business Mailing Address
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Address Line | 1425 E LINCOLN RD SUITE B-1
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City | IDABEL
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State | OK
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Zip | 74745-7345
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Country | US
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Telephone | 580-286-4949
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Fax | 580-286-4946
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE EDWARD FREEMAN
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Credential | DO
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Telephone | 580-286-4949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 3192
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License Number State | OK
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