Individual
DR. DANIEL JONATHAN FREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
42783
CO
207RG0100X
Gastroenterology Physician
A-1716-12
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073048
—
NM
01
—
266636YM5A
MEDICARE- LMG
NM
05
—
68473711
—
CO
Enumeration date
01/17/2006
Last updated
02/25/2016
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