Individual
TAMIKA D USSERY-FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 REDSTONE AVE W STE 390, CRESTVIEW, FL 32536-6434
(850) 683-5100
(850) 683-5102
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
052846
GA
208000000X
Pediatrics Physician
Primary
ME114418
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406306123A
—
GA
Enumeration date
03/01/2006
Last updated
01/19/2021
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