Breaux, Jack L.
Breaux, Jack L. is an sole proprietor health care provider with primary practice located at 8080 Bluebonnet Blvd Ste 2222, Baton Rouge LA 70810-7828. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Breaux, Jack L. can be contacted via phone (225) 769-2222.Contact Information
Primary practice address
8080 Bluebonnet Blvd Ste 2222
Baton Rouge LA 70810-7828
Phone: (225) 769-2222
Fax: (225) 757-8061
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 013762 | Louisiana |
Profile Details
| NPI number | 1720081193 |
|---|---|
| LBN Legal business name | Breaux, Jack L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2005 |
| Last updated | Mar 5th, 2024 - about 9 months 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 | 1720081193 | NPPES |
| Louisiana | MEDICAID | 1185761 |
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