Freeman, Gordon Glenn
Freeman, Gordon Glenn is an sole proprietor health care provider with primary practice located at 3891 Highway 78 W , Snellville GA 30039-3932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Freeman, Gordon Glenn can be contacted via phone (770) 972-4764.Contact Information
Primary practice address
3891 Highway 78 W
Snellville GA 30039-3932
Phone: (770) 972-4764
Fax: (770) 972-4164
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 023958 | Georgia |
Profile Details
| NPI number | 1083652267 |
|---|---|
| LBN Legal business name | Freeman, Gordon Glenn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Aug 19th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083652267 | NPPES |
| Georgia | Other | 52260821-001 | BLUE CROSS BLUE SHIELD PROVIDER ID |
| Georgia | Other | 1568628618 | BLUE CROSS BLUE SHIELD PROVIDER ID |
| Georgia | Other | 4073314 | BLUE CROSS BLUE SHIELD PROVIDER ID |
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