Breazeale, Richard I

Breazeale, Richard I is an individual health care provider with primary practice located at 1605 Williams Rd Ste 201, Hixson TN 37343-4934. He recently has only one registered license in Allopathic & Osteopathic Physicians / Retina Specialist, which is considered as his primary health care specialty. Breazeale, Richard I can be contacted via phone (423) 756-1512.

Contact Information

Primary practice address
1605 Williams Rd Ste 201 Hixson TN 37343-4934
Phone: (423) 756-1512
Fax: (423) 756-1004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 56089 Georgia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 31597 Tennessee

Profile Details

NPI number 1801892146
LBN Legal business name Breazeale, Richard I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Dec 3rd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801892146 NPPES
Georgia MEDICAID 000860318C
Georgia MEDICAID 009937405
Georgia MEDICAID 3841514
Georgia MEDICAID 000860318E

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