| Freeman Family Practice Llc | |
|
10755 N Us Highway 25e Gray KY 40734-6529 | |
| (606) 258-8050 | |
| (606) 258-8994 |
| Full Name | Freeman Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10755 N Us Highway 25e, Gray, Kentucky |
| Authorized Official Name and Position | Tammy L Freeman (OWNER) |
| Authorized Official Contact | 6062588050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freeman Family Practice Llc 10755 N Us Highway 25e Gray KY 40734-6529 Ph: (606) 258-8050 | Freeman Family Practice Llc 10755 N Us Highway 25e Gray KY 40734-6529 Ph: (606) 258-8050 |
| NPI Number | 1750557302 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 05/12/2014 |
| Medicare PECOS PAC ID | 8325119605 |
|---|---|
| Medicare Enrollment ID | O20080613000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750557302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 900220 (Kentucky) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 2597P (Kentucky) | Secondary |
| Provider Name | Tammy L Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023105780 PECOS PAC ID: 5395659320 Enrollment ID: I20050822000375 |
| Provider Name | Gina Lori Bowlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114591773 PECOS PAC ID: 3375943483 Enrollment ID: I20210610003332 |
Knox County Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Cumberland Gap Plz, Gray, KY 40734 Phone: 606-528-2850 Fax: 606-528-1131 |