Provider Demographics
NPI:1114985785
Name:FREEMAN, THOMAS SMITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SMITH
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-1114
Mailing Address - Country:US
Mailing Address - Phone:770-253-9894
Mailing Address - Fax:
Practice Address - Street 1:121 JACKSON ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1572
Practice Address - Country:US
Practice Address - Phone:770-251-5873
Practice Address - Fax:770-304-2201
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2042103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00727658CMedicaid
GA00727658CMedicaid