Provider Demographics
NPI:1861075129
Name:FREELAND, JORDAN (DO)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:FREELAND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-3869
Mailing Address - Country:US
Mailing Address - Phone:864-725-4865
Mailing Address - Fax:
Practice Address - Street 1:3774 VALLEY RD
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-4614
Practice Address - Country:US
Practice Address - Phone:304-258-9433
Practice Address - Fax:304-258-6063
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4439207Q00000X
SC83578207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine