Provider Demographics
NPI:1437295730
Name:FREEL, ARTHUR DALE (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:DALE
Last Name:FREEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 VENTURE P.2 LN
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MI
Mailing Address - Zip Code:49837-2615
Mailing Address - Country:US
Mailing Address - Phone:906-428-1381
Mailing Address - Fax:
Practice Address - Street 1:301 N LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1387
Practice Address - Country:US
Practice Address - Phone:906-789-0668
Practice Address - Fax:906-789-9752
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI2537152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U35138Medicare UPIN