Provider Demographics
NPI:1326094079
Name:FREEMAN, JOHN CAMPBELL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CAMPBELL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 7 LKS N
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9760
Mailing Address - Country:US
Mailing Address - Phone:800-261-0048
Mailing Address - Fax:
Practice Address - Street 1:612 MOCKSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2732
Practice Address - Country:US
Practice Address - Phone:704-210-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93-00470207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8933876Medicaid
NC93-00470OtherLICENSE
NC33876OtherBLUE CROSS BLUE SHIELD
NC39-11995OtherUHC
NC809087OtherPARTNERS
NC809087OtherPARTNERS
NC39-11995OtherUHC
NC809087OtherPARTNERS
C92661Medicare UPIN