Basic Information
| Provider Information | |||||||||
| NPI: | 1861999583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREIBERG | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | ALEXANDER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1161 21ST AVE S | ||||||||
| Address2: | A-2200 MEDICAL CENTER NORTH | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153222035 | ||||||||
| FaxNumber: | 6153436160 | ||||||||
| Practice Location | |||||||||
| Address1: | 1161 21ST AVE S | ||||||||
| Address2: | A-2200 MEDICAL CENTER NORTH | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153222035 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2018 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.