MEDICARE: DR. FREDDIE L TERRELL MD

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	208800000X	Urology Physician	29797	KY

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	:	1548268279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDDIE L TERRELL MD

Provider Business Mailing Address
First Line	:	1114 MCCANN DR
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1157
Country	:	US
Telephone Number	:	859-737-4411
Fax Number	:	859-737-2123

Provider Business Practice Location Address
First Line	:	1114 MCCANN DR
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1157
Country	:	US
Telephone Number	:	859-737-4411
Fax Number	:	859-737-2123

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	03/28/2013

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