Provider Demographics
NPI:1144220443
Name:FREEMAN, FRANK MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MICHAEL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-0583
Mailing Address - Country:US
Mailing Address - Phone:256-586-4171
Mailing Address - Fax:256-586-9790
Practice Address - Street 1:7 12TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1977
Practice Address - Country:US
Practice Address - Phone:256-586-4171
Practice Address - Fax:256-586-9790
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS356TA201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528800620Medicaid
ALS356TA201OtherSTATE LICENSE NUMBER
AL51059669OtherBC PROVIDER NUMBER
AL630731355OtherEMPLOYER IDENTIFICATION N
AL630731355OtherEMPLOYER IDENTIFICATION N
AL000059669Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALMF0175326OtherFEDERAL DEA NUMBER
AL528800620Medicaid