MEDICARE: DR. CRAIG K FREEDMAN M.D.

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	2085R0202X	Diagnostic Radiology Physician	H9933	TX

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	:	1447226113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG K FREEDMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1547
Second Line	:
City	:	SEDALIA
State	:	MO
Zip	:	65302-1547
Country	:	US
Telephone Number	:	660-826-5960
Fax Number	:	660-826-4852

Provider Business Practice Location Address
First Line	:	100 MEDICAL DRIVE
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5674
Country	:	US
Telephone Number	:	979-285-1937
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	03/07/2014

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