Individual
MR. JOHN C FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR-MD
Contact information
Practice address
1510 12TH AVE RD, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M10239
ID
208000000X
Pediatrics Physician
Primary
M10239
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8080229
—
ID
01
—
P00652182
RAILROAD MEDICARE
—
Enumeration date
03/29/2007
Last updated
03/05/2024
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