Breaux, Charles W
Breaux, Charles W is an individual health care provider with primary practice located at 2643 Patterson Rd Suite 603, Grand Junction CO 81506-1936. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Breaux, Charles W can be contacted via phone (970) 298-7440.Contact Information
Primary practice address
2643 Patterson Rd Suite 603
Grand Junction CO 81506-1936
Phone: (970) 298-7440
Fax: (970) 298-7459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 35211 | Colorado |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 11154 | Alabama |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 35211 | Colorado |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 11154 | Alabama |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 35211 | Colorado |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 11154 | Alabama |
Profile Details
| NPI number | 1407844301 |
|---|---|
| LBN Legal business name | Breaux, Charles W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Jul 18th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407844301 | NPPES |
| Colorado | MEDICAID | 01352111 | |
| Colorado | MEDICAID | 10025031 | |
| Colorado | MEDICAID | 100504625 | |
| Colorado | Other | BRB1426 |
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