Provider Demographics
NPI:1558581140
Name:FREULER, JAMES MORGAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MORGAN
Last Name:FREULER
Suffix:
Gender:M
Credentials:PA-C
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 5
Mailing Address - Street 2:MILE 187 GLENN HIGHWAY
Mailing Address - City:GLENNALLEN
Mailing Address - State:AK
Mailing Address - Zip Code:99588-0005
Mailing Address - Country:US
Mailing Address - Phone:907-822-3203
Mailing Address - Fax:
Practice Address - Street 1:149 WALNUT GROVE CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321
Practice Address - Country:US
Practice Address - Phone:423-775-5512
Practice Address - Fax:423-775-0155
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK109593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNR14836Medicare UPIN