Provider Demographics
NPI:1619428471
Name:FREEMAN, THOMAS II
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:FREEMAN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 H C MCCRAY JR DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-5613
Mailing Address - Country:US
Mailing Address - Phone:850-866-1102
Mailing Address - Fax:888-510-0308
Practice Address - Street 1:3815 H C MCCRAY JR DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-5613
Practice Address - Country:US
Practice Address - Phone:850-866-1102
Practice Address - Fax:888-510-0308
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information