Provider Demographics
NPI:1427540152
Name:FREEDOM EYE CARE INC
Entity Type:Organization
Organization Name:FREEDOM EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-636-4300
Mailing Address - Street 1:3500 SE CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-5182
Mailing Address - Country:US
Mailing Address - Phone:479-636-4300
Mailing Address - Fax:479-636-4434
Practice Address - Street 1:3500 SE CLUB BLVD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5182
Practice Address - Country:US
Practice Address - Phone:479-636-4300
Practice Address - Fax:479-636-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty