Provider Demographics
NPI:1477632263
Name:FREEMAN, WILLARD BILL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:BILL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DC
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 956
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-0956
Mailing Address - Country:US
Mailing Address - Phone:405-379-6992
Mailing Address - Fax:
Practice Address - Street 1:105 S HINCKLEY ST
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-5263
Practice Address - Country:US
Practice Address - Phone:405-379-6992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU50613Medicare UPIN