Organization
DR PENNY FRESHOUR OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PENNY FRESHOUR (OWNER)
(501) 791-0660
Entity
Organization
Contact information
Practice address
3929 MCCAIN BLVD, #G07A, NORTH LITTLE ROCK, AR 72116-8011
(501) 791-0660
(501) 753-4401
Mailing address
3929 MCCAIN BLVD, #G07A, NORTH LITTLE ROCK, AR 72116-8011
(501) 791-0660
(501) 753-4401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2483
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19983000040
QUALCHOICE
AR
01
—
AR2483
AR LICENSE
AR
01
—
P00273197
RAILROAD MEDICARE
AR
Enumeration date
01/09/2007
Last updated
08/22/2020
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