Provider Demographics
NPI:1396747648
Name:FREEMAN, WILLIAM H (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:H
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:600 CLUB LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3624
Mailing Address - Country:US
Mailing Address - Phone:501-327-0110
Mailing Address - Fax:501-327-0141
Practice Address - Street 1:600 CLUB LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3624
Practice Address - Country:US
Practice Address - Phone:501-327-0110
Practice Address - Fax:501-327-0141
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6022207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1396747648OtherINDIVIDUAL NPI
AR04D0957619OtherCLIA NUMBER
AR110995001Medicaid
AR110995001Medicaid
AR51787Medicare PIN
AR51787G546Medicare PIN
ARC68314Medicare UPIN
AR5G546Medicare PIN
AR1396747648OtherINDIVIDUAL NPI