Individual
LARRY T BREEDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Mailing address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101247081
VA
207RC0000X
Cardiovascular Disease Physician
29754
KY
207RC0000X
Cardiovascular Disease Physician
Primary
34198
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3854776
—
TN
05
—
6404087600
—
KY
Enumeration date
07/07/2006
Last updated
07/28/2015
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