Basic Information
| Provider Information | |||||||||
| NPI: | 1417903790 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREEMAN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 110B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MACUNGIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180621120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109674993 | ||||||||
| FaxNumber: | 4844034020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 08/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS009668L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0848234000 | 01 | PA | AMERIHEALTH (IBC) | OTHER | 2529917 | 01 | PA | AETNA | OTHER | 843774 | 01 | PA | KEYSTONE CENTRAL | OTHER | 18368990003 | 05 | PA | MEDICAID | 843774 | 01 | PA | AMERIHEALTH | OTHER | 843774 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | P3172314 | 01 | PA | OXFORD | OTHER | 50014245 | 01 | PA | CAPITAL | OTHER | 0848234000 | 01 | PA | KEYSTONE EAST | OTHER | 110248389 | 01 | PA | RAILROAD MEDICARE | OTHER |