Provider Demographics
NPI:1295906212
Name:FREESTONE, DARICK HATHAWAY (DPM)
Entity type:Individual
Prefix:DR
First Name:DARICK
Middle Name:HATHAWAY
Last Name:FREESTONE
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 S. VAL VISTA DR
Mailing Address - Street 2:SUITE 177, BLDG 14
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-4234
Mailing Address - Country:US
Mailing Address - Phone:480-909-3700
Mailing Address - Fax:877-839-9972
Practice Address - Street 1:2680 S. VAL VISTA DR. SUITE 177, BLDG 14
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4234
Practice Address - Country:US
Practice Address - Phone:480-909-3700
Practice Address - Fax:877-839-9972
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002258213ES0103X
AZ0708213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery