Individual
MR. BRETTON HOWARD BREAZEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 DAGGETT AVE, KLAMATH FALLS, OR 97601
(541) 205-3974
(541) 205-5652
Mailing address
PO BOX 7326, KLAMATH FALLS, OR 97602-0326
(541) 205-3974
(541) 205-5652
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD26555
OR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD26555
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213057
—
OR
05
—
XPY204768
—
CA
Enumeration date
08/28/2006
Last updated
06/23/2014
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