Freeman, Tijuana Lisette

Freeman, Tijuana Lisette is an individual health care provider with primary practice located at 3650 Groveland Rd , Ocean Springs MS 39564-5753. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Freeman, Tijuana Lisette can be contacted via phone (228) 875-0780.

Contact Information

Primary practice address
3650 Groveland Rd Ocean Springs MS 39564-5753
Fax: (228) 875-1009
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 15040 Mississippi
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-1828 Arkansas

Profile Details

NPI number 1952366080
LBN Legal business name Freeman, Tijuana Lisette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Dec 29th, 2011 - about 15 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 1952366080 NPPES
Arkansas MEDICAID 135418001
Arkansas Other 1832000000
Arkansas Other 1222017

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