Provider Demographics
NPI:1679626675
Name:SEMMLER, MICHAEL TODD (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TODD
Last Name:SEMMLER
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 1:101 PLAZA CARMONA PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-3000
Mailing Address - Country:US
Mailing Address - Phone:501-922-5778
Mailing Address - Fax:501-922-6659
Practice Address - Street 1:101 PLAZA CARMONA PL
Practice Address - Street 2:SUITE C
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-3000
Practice Address - Country:US
Practice Address - Phone:501-922-5778
Practice Address - Fax:501-922-6659
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR 2435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5B824Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
AR51267Medicare UPIN