Individual
BYRON MICHAEL BREEDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
144 EDENWOOD DR, JACKSON, TN 38301-3827
(731) 256-1466
Mailing address
144 EDENWOOD DR, JACKSON, TN 38301-3827
(731) 256-1466
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0000001272
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3701995
—
TN
01
—
P00292468
RAILROAD MEDICARE
—
Enumeration date
11/09/2005
Last updated
09/30/2009
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