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:
Health care specialties
| Specialty | Code | License # | 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 6 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 | 1801892146 | NPPES |
| Georgia | MEDICAID | 000860318C | |
| Georgia | MEDICAID | 009937405 | |
| Georgia | MEDICAID | 3841514 | |
| Georgia | MEDICAID | 000860318E |
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