Provider Demographics
NPI:1134196132
Name:FREELY, ALISON B (DO)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:B
Last Name:FREELY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 HYBART ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5907
Mailing Address - Country:US
Mailing Address - Phone:672-575-3682
Mailing Address - Fax:
Practice Address - Street 1:301 NORMANDY DRIVE
Practice Address - Street 2:#4-1830
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28307
Practice Address - Country:US
Practice Address - Phone:910-643-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC175308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101266969Medicaid
PA091627Medicare ID - Type Unspecified
PA101266969Medicaid