Individual
DR. MARK ALBERT BREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11500 HANNON RD, EAGLE POINT, OR 97524-9598
(541) 849-3168
Mailing address
1801 POPLAR DR APT 44, MEDFORD, OR 97504-4675
(541) 840-3168
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3410ATI
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/07/2009
Last updated
08/31/2011
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