MEDICARE: GEORGE EDWARD FREEMAN, D.O.,P.C.

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	207R00000X	Internal Medicine Physician	3192	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124194568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE EDWARD FREEMAN, D.O.,P.C.

Provider Business Mailing Address
First Line	:	1425 E LINCOLN RD
Second Line	:	SUITE B-1
City	:	IDABEL
State	:	OK
Zip	:	74745-7345
Country	:	US
Telephone Number	:	580-286-4949
Fax Number	:	580-286-4946

Provider Business Practice Location Address
First Line	:	1425 E LINCOLN RD
Second Line	:	SUITE B-1
City	:	IDABEL
State	:	OK
Zip	:	74745-7345
Country	:	US
Telephone Number	:	580-286-4949
Fax Number	:	580-286-4946

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GEORGE EDWARD FREEMAN
Credential	:	DO
Telephone Number	:	580-286-4949

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/10/2011

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