MEDICARE: DR. JON K. FRECKLETON D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DR.0044022	CO

General Provider Information

NPI Number	:	1114196615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON K. FRECKLETON D.O.

Provider Business Mailing Address
First Line	:	2221 IDELLA CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-7019
Country	:	US
Telephone Number	:	970-629-0644
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 IDELLA CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-7019
Country	:	US
Telephone Number	:	970-629-0644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	03/26/2026

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