Provider Demographics
NPI:1043394539
Name:FREEDMAN, BAZIL ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:BAZIL
Middle Name:ERIC
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BAZIL
Other - Middle Name:ERIC
Other - Last Name:FREEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2240 KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-344-5846
Mailing Address - Fax:
Practice Address - Street 1:2411 MARTIN LUTHER KING JNR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-682-7575
Practice Address - Fax:541-682-7590
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10211174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR06451-9Medicaid
ORC92659Medicare UPIN
OR0000BHNCHMedicare ID - Type Unspecified