Individual
DR. LAWRENCE J BRECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 E MISSOURI AVE, 600, PHOENIX, AZ 85014-2707
(602) 277-4455
(602) 277-9654
Mailing address
1110 E MISSOURI AVE, 600, PHOENIX, AZ 85014-2707
(602) 277-4455
(602) 277-9654
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7945
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071627735
PALMETTO GBA RAILROAD MED
AZ
01
—
245979
AHCCCS
AZ
01
—
AZ0053690
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/02/2005
Last updated
06/12/2012
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