Provider Demographics
NPI:1003855560
Name:FREEMAN, LUCIUS BEDFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIUS
Middle Name:BEDFORD
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 MCQUEEN SMITH RD N
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7268
Mailing Address - Country:US
Mailing Address - Phone:334-361-7656
Mailing Address - Fax:334-361-4665
Practice Address - Street 1:645 MCQUEEN SMITH RD N
Practice Address - Street 2:SUITE 105
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7268
Practice Address - Country:US
Practice Address - Phone:334-361-7656
Practice Address - Fax:334-361-4665
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21057207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine