Individual
DR. KENTON C. FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
218 S WOODBINE RD, SAINT JOSEPH, MO 64506-3447
(816) 383-3680
Mailing address
2201 RED OAK CT, SAINT JOSEPH, MO 64506-4936
(816) 233-0211
(816) 233-8196
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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