Provider Demographics
NPI:1528069051
Name:FREELS, DOUGLAS B (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:B
Last Name:FREELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 FOX MEADOWS BLVD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6939
Mailing Address - Country:US
Mailing Address - Phone:828-755-4027
Mailing Address - Fax:
Practice Address - Street 1:1108 FOX MEADOWS BLVD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6939
Practice Address - Country:US
Practice Address - Phone:865-366-4908
Practice Address - Fax:865-366-1584
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29155207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ056062Medicaid
TNT13590AOtherMEDICARE