Provider Demographics
NPI:1255499737
Name:FRESHWATER, JAMES W JR (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:FRESHWATER
Suffix:JR
Gender:M
Credentials:OD
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Mailing Address - Street 1:6270 TOWNCENTER DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9376
Mailing Address - Country:US
Mailing Address - Phone:336-712-4733
Mailing Address - Fax:336-712-4704
Practice Address - Street 1:6270 TOWNCENTER DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9376
Practice Address - Country:US
Practice Address - Phone:336-712-4733
Practice Address - Fax:336-712-4704
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-09-10
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Provider Licenses
StateLicense IDTaxonomies
NC1258152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1922148840OtherNPI TIMOTHY JAMESON, O.D.
NC1255499737OtherNPI JAMES FRESHWATER, O.D
NC2469546Medicare PIN
NC1922148840OtherNPI TIMOTHY JAMESON, O.D.
NC1255499737OtherNPI JAMES FRESHWATER, O.D
NC2467373AMedicare ID - Type Unspecified