Basic Information
| Provider Information | |||||||||
| NPI: | 1790036911 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | FLOYD | ||||||||
| FirstName: | FREEMAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1815 PLEASANT GROVE ROAD | ||||||||
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| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709336886 | ||||||||
| FaxNumber: | 8709339395 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 JAMES STREET | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019825000 | ||||||||
| FaxNumber: | 5019825007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2012 | ||||||||
| LastUpdateDate: | 09/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174V00000X | Y | Other Service Providers | Clinical Ethicist |
No ID Information.