Provider Demographics
NPI:1184604498
Name:FREENOCK, THOMAS FRANCIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:FREENOCK
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:24 DOCTORS LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8568
Mailing Address - Country:US
Mailing Address - Phone:814-226-2510
Mailing Address - Fax:814-226-2511
Practice Address - Street 1:24 DOCTORS LN
Practice Address - Street 2:SUITE 104
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8568
Practice Address - Country:US
Practice Address - Phone:814-226-2510
Practice Address - Fax:814-226-2511
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2015-08-07
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Provider Licenses
StateLicense IDTaxonomies
PAMD035051E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001491300007Medicaid
PAE71411Medicare UPIN
PA001491300007Medicaid