Provider Demographics
NPI:1548232416
Name:FREEDMAN MEMORIAL CARDIOLOGY
Entity Type:Organization
Organization Name:FREEDMAN MEMORIAL CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-767-0960
Mailing Address - Street 1:3311 PRESCOTT RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3900
Mailing Address - Country:US
Mailing Address - Phone:318-767-0960
Mailing Address - Fax:318-767-0610
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-767-0960
Practice Address - Fax:318-767-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1142925Medicaid
LACJ7561OtherRAILROAD MEDICARE
LA5CA45Medicare PIN