Provider Demographics
NPI:1083696363
Name:FREED, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:FREED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1370 N INTERSTATE DR
Mailing Address - Street 2:SUITE 154
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3376
Mailing Address - Country:US
Mailing Address - Phone:405-224-8111
Mailing Address - Fax:405-222-9587
Practice Address - Street 1:2222 W IOWA AVE
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2738
Practice Address - Country:US
Practice Address - Phone:405-224-8111
Practice Address - Fax:405-222-9587
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK9544208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100116640AMedicaid
D91071Medicare UPIN