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
Fax: (770) 972-4164
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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