Provider Demographics
NPI:1558375733
Name:FREEMAN, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:FREEMAN
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 1:125 B WAMSUTTA MILL RD.
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5522
Mailing Address - Country:US
Mailing Address - Phone:828-430-3511
Mailing Address - Fax:828-430-3513
Practice Address - Street 1:838 STATE FARM RD.
Practice Address - Street 2:SU:2
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5391
Practice Address - Country:US
Practice Address - Phone:828-386-1001
Practice Address - Fax:828-358-1317
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18948208D00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC33820OtherBCBS
NC8933820Medicaid
TN4173162Medicaid
NC2031811Medicare PIN
NCC81264Medicare UPIN