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Contact Information

FREEMAN R JACKSON JR, MD
600 GREEN VALLEY ROAD
SUITE 304
GREENSBORO, NC27408
 Phone: 336-282-4840
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for FREEMAN R JACKSON JR · (Male)

NPI Number 1013131994
Status Active
Credentials MD
Entity Individual
Enumeration date 04/12/2007
Last updated 11/21/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • NC License # 2009-00104
  • NC Other P00969101 RAILROAD-MEDICARE
Hospital affiliation(s)
  • PRESBYTERIAN HOSPITAL - (Acute Care)
    200 HAWTHORNE LANE BOX 33549
    CHARLOTTE, NC 28233
  • PRESBYTERIAN HOSPITAL MATTHEWS - (Acute Care)
    1500 MATTHEWS TWNSHP PRKWY BOX 3310
    MATTHEWS, NC 28106
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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