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Individual
DR. KENTON C. FREEMAN
Active
Individual
DR. KENTON C. FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
104065
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008108
MEDICARE PROV #
MO
05
—
208721506
—
MO
01
—
24719017
BC/BS OF KC
MO
01
—
250008744
RR MEDICARE #
MO
01
—
G50233
UPIN
MO
Enumeration date
11/07/2005
Last updated
03/12/2020
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