Individual
JACOB LEE BREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 COOLIDGE BLVD STE 303, LAFAYETTE, LA 70503
(337) 232-6697
(337) 232-6605
Mailing address
1211 COOLIDGE BLVD STE 303, LAFAYETTE, LA 70503-2636
(337) 232-6697
(337) 232-6605
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD.207307
LA
Other
Enumeration date
04/12/2012
Last updated
05/23/2018
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