Organization
E. PAUL BREAUX III MD PMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR PAUL BREAUX III M.D. (OWNER/MANAGING MEMBER)
(337) 237-5774
Entity
Organization
Contact information
Practice address
917 COOLIDGE BLVD, LAFAYETTE, LA 70503-2433
(337) 237-5774
(337) 237-4939
Mailing address
917 COOLIDGE BLVD, LAFAYETTE, LA 70503-2433
(337) 237-5774
(337) 237-4939
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1799467
—
LA
01
—
DE1593
GROUP RAILROAD MEDICARE #
LA
Enumeration date
05/20/2006
Last updated
07/13/2007
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