Provider Demographics
NPI:1053477828
Name:JAMES M FREEMAN MD
Entity Type:Organization
Organization Name:JAMES M FREEMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-312-7600
Mailing Address - Street 1:PO BOX 71906
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-1906
Mailing Address - Country:US
Mailing Address - Phone:229-312-7600
Mailing Address - Fax:229-312-7605
Practice Address - Street 1:803 N JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-5117
Practice Address - Country:US
Practice Address - Phone:229-312-7600
Practice Address - Fax:229-312-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0087642083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000158463BMedicaid
GA252520377BMedicare PIN