Provider Demographics
NPI:1982721882
Name:WILLIAM H. FREEMAN, M.D., P.A.
Entity Type:Organization
Organization Name:WILLIAM H. FREEMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-327-0110
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131627002Medicaid
AR04D0957619OtherCLIA NUMBER
ARC6022OtherLICENSE
AR1982721882OtherGROUP NPI
AR110995001Medicaid
AR1982721882OtherGROUP NPI
ARC68314Medicare UPIN
AR110995001Medicaid
ARP00861551Medicare PIN
AR5G546Medicare PIN
AR131627002Medicaid