MEDICARE: DR. SUSAN FREE SEMMLER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	AR 2436	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982757985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN FREE SEMMLER O.D.

Provider Business Mailing Address
First Line	:	101 PLAZA CARMONA PL
Second Line	:	SUITE C
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3000
Country	:	US
Telephone Number	:	501-922-5778
Fax Number	:	501-922-6659

Provider Business Practice Location Address
First Line	:	101 PLAZA CARMONA PL
Second Line	:	SUITE C
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3000
Country	:	US
Telephone Number	:	501-922-5778
Fax Number	:	501-922-6659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2007
Last Update Date	:	07/09/2007

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