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General NPI Number Information
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NPI Number | 1902562739
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Entity Type | Organization
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Legal Business Name | FREEDOCTOR, INC
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 114 ARBOR LN
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-5793
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Country | US
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Telephone | 850-776-4497
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1790
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-1790
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | CHELSEA ANNE SMITH
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Credential |
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Telephone | 850-480-5629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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