Individual
DR. JACK L. BREAUX JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8080 BLUEBONNET BLVD, STE 2222, BATON ROUGE, LA 70810-7828
(225) 769-2222
(225) 757-8061
Mailing address
604 N ACADIA RD STE 101, THIBODAUX, LA 70301-4897
(985) 446-5079
(985) 447-2497
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
013762
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1185761
—
LA
Enumeration date
05/31/2005
Last updated
12/02/2024
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