Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0131X | Foot Surgery | 000712 | MO |
Y | 213ES0131X | Foot Surgery | 016-003720 | IL |
NPI | 1184614653 |
---|---|
Provider Name | Dr. Douglas John Freel |
First Address | Quincy, IL 62301-3027 |
Second Address | Quincy, IL 62301-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 09/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00132005 | BLUE CROSS/BLUE SHIELD (01) | IL |
009464 | HEALTH ALLIANCE (01) | |
1184614653 | (05) | MO |
127214 | HEALTHLINK (01) | |
3074226001 | CIGNA (01) | |
T38187 | (02) |